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Page 1: Andre Tylee and Alan Cohen: Incorporating psychological therapies in the treatment of chronic conditions

Relieving distress, transforming lives

Incorporating psychological therapies in the

management of LTC – the role of IAPT

Dr Alan Cohen FRCGP

Director of Primary Care

West London MH Trust

Page 2: Andre Tylee and Alan Cohen: Incorporating psychological therapies in the treatment of chronic conditions

A game of two halves

Page 3: Andre Tylee and Alan Cohen: Incorporating psychological therapies in the treatment of chronic conditions

What we are going to cover…

• A review of what was achieved in the first three years– me

• A look at what will be achieved in the next three years– Andre

Page 4: Andre Tylee and Alan Cohen: Incorporating psychological therapies in the treatment of chronic conditions

The first three years

• Special interest group for LTCs and MUS• Commitment and support of all primary

care organisations• Identified regional and local leads• Supported with a training/leadership

programme

Page 5: Andre Tylee and Alan Cohen: Incorporating psychological therapies in the treatment of chronic conditions

The first three years• Training programmes at RCGP e-learning and

BMJ on-line• A study using electronic recording of Med3/5 in

the management of anxiety/depression including LTCs

• St Georges Study• Collaborative Care – commissioning package

Page 6: Andre Tylee and Alan Cohen: Incorporating psychological therapies in the treatment of chronic conditions

Thank you

[email protected]

Page 7: Andre Tylee and Alan Cohen: Incorporating psychological therapies in the treatment of chronic conditions

IAPT: LTC Work Stream

Prof André Tylee MD FRCGP MRCPsych

Expert advisor, LTCs

Page 8: Andre Tylee and Alan Cohen: Incorporating psychological therapies in the treatment of chronic conditions

Plan

• Multiple LTCs and multiple bio-psycho-social needs often co-exist

• Some initial IAPT plans• Call for good examples

Page 9: Andre Tylee and Alan Cohen: Incorporating psychological therapies in the treatment of chronic conditions

CHD with distress or Depression.

Often a ‘personal and social story’ of loss

Interpersonalfactors and

Loss

Health andloss

Control

Emasculation’ Loss of sexualIntimacy and

self worth

LonelinessIsolation

Bereavement/grief

Relationship breakdown: partner

and children

AgingMulti-morbidity++

Fear of future

May dislike drug side effects

May prefer their own self help approaches (e.g yoga)

Erectiledysfunction

Loss of employmentand self worth

Lack of finances

May be a carer also: lost

freedom

Many think PCPs have a key role

Prefer talking RX and self help

Some like groups

Patients may have a wide range of psychosocial needs and preferences

Page 10: Andre Tylee and Alan Cohen: Incorporating psychological therapies in the treatment of chronic conditions

• Approximately £1.7 million 2011/12 commitment to LTC/MUS

developmental work

• Scoping work underway including mapping

• Initial elements: compendium; collaborative care pathways; economic

calculator/analysis• Phase 1 – developmental, likely to involve testing and evaluating good

practice• Engaging key stakeholders including CCGs• Expert Reference Group to meet by Nov 2011

IAPT LTC – moving forward

Page 11: Andre Tylee and Alan Cohen: Incorporating psychological therapies in the treatment of chronic conditions

Good practice examples needed

• Training for IAPT workers • Collaborative care projects• Case management• Personalised care • Psycho-education• Facilitated groups• Multi-morbidity• Etc

Page 12: Andre Tylee and Alan Cohen: Incorporating psychological therapies in the treatment of chronic conditions

Thank [email protected]

Special thanks to;

[email protected] Projects Development Lead

IAPT, Department of Health