From here to I.A.P.T? (improving access to psychological therapies), preview for a new deal for dynamic psychotherapies: The psychoanalyst as street-level bureaucrat

Abstract

This paper offers a preview of a forthcoming article on the world's first, universal free-to-access, evidence-based talking therapies programme to treat depression: Improving Access to Psychological Therapies. It was pioneered not in the USA, but the UK, in 2007. At one time it could have been led by psychoanalysts, but it wasn't. It was a New Deal, in fact, for CBT. But did this New Deal in 2007 also offer psychoanalysis an opportunity to renew its vitality as a discipline, after decades of being eroded by our long-term retreat into private practice? Illustrated in the film From Here to Eternity, through characters played by Burt Lancaster, Montgomery Clift and Frank Sinatra, this Preview shows how applied psychoanalysis can once again aspire to become a universal, genuinely popular, relevant professional discipline. How would we engage ethically with psychiatric casualties of war, for example, within an evidence-based practice framework today? A novel, brief psychoanalytic treatment for depression, Dynamic Interpersonal Therapy, was developed for use in the UK's Improving Access to Psychological Therapies (IAPT) programme. It is recommended by NICE (National Institute for Health and Care Excellence) as cost-effective for treating depression. By engaging with evidence-based practice in this way—as Street Level Bureaucrats—we can reclaim our position at the centre of contemporary publicly funded mental health services.