A naturalistic pilot study assessing the impact of assessment pathways and intake methods within Improving Access to Psychological Therapies services

Fast access pathways characterise many Improving Access to Psychological Therapy (IAPT) services, allowing them to see increasing numbers of referrals year on year. At the same time, emerging research is highlighting potential care inefficiencies, including early treatment disengagement, inappropriate treatment allocation, less than optimal clinical outcomes, and repeat referrals. Integrating more stratified models based on in-depth and comprehensive assessment techniques which include some therapeutic input could help better target interventions. This could lead to improved engagement and clinical outcomes, while also providing enough therapeutic support to those attending one session only. This pilot study assesses the impact of assessment pathways and intake methods involving a 90-min face-to-face therapeutic consultation, compared with a 45-min over-the-phone assessment session across two IAPT providers in the south of England, and three assessment pathways involving elements of either method and service. Using an observational analysis of routinely collected data across 12 months, intake scores, attendance data and clinical measures of reliable recovery and improvement were considered. The comparisons of intake method reported no significant differences when both services were included; however, there were significant differences in treatment effect sizes and session attendance on an assessment pathway basis. Where assessment sessions were delivered, there was a higher rate of disengagement between sessions one and two, indicating increased attrition. Based on the initial findings and supporting literature, there appears to great promise in exploring pathway modelling and intake processes within IAPT services.