Optimising telephone delivery of Improving Access to Psychological Therapies (IAPT)

The IAPT programme delivers therapy to people across England. It’s an important part of the national strategy to reduce harms caused by poor mental health, including self-harm. Even before the COVID-19 pandemic began, IAPT was offering therapy both in-person and by telephone.

However, telephone delivery of IAPT was often considered to be problematic. Our research informed a new intervention to change the behaviours of patients, clinicians and key informants (such as service managers) to increase the overall effectiveness of IAPT delivered by telephone.

Our systematic review showed that telephone delivery of IAPT was just as good as when it is delivered face-to-face. This finding reduced concerns expressed by patients and professionals around choosing care delivered over the telephone.

In 2020, this evidence was summarised in an NIHR Alert and was the basis of our intervention.

To gain the perspectives of multiple stakeholders, we carried out an analysis based on theory of therapy sessions, interviews with patients, healthcare professionals, and other key stakeholders.

This helped us to design the content for our quality improvement intervention. This includes service guidelines, training for healthcare professionals, and resources for patients that will enhance the delivery of psychological therapies via telephone.

During the COVID-19 pandemic, from October 2020 to January 2021, we worked with NHS England to deliver training to more than 400 IAPT practitioners (70% working in high intensity settings) across 60 services.

Surveys taken before and after this training highlighted improvements in practitioners’ capabilities and motivations. We were therefore an important resource in terms of helping services to transition to telephone delivery, and NHS England subsequently funded the development of a standalone online training package that is now being rolled out.

Relevant publications

• A case of misalignment: the perspectives of local and national decision-makers on the implementation of psychological treatment by telephone in the Improving Access to Psychological Therapies Service.
• Enhancing the Behaviour Change Wheel with synthesis, stakeholder involvement and decision-making: a case example using the Enhancing the Quality of Psychological Interventions Delivered by Telephone (EQUITy) research programme.
• Are there interactional differences between telephone and face-to-face psychological therapy? A systematic review of comparative studies.