The evidence behind psychological therapies
|Type of research
Depression and anxiety in adults together represent the largest
proportion of significant mental health problems in the UK. UCL
research has been used to develop a programme supporting speedy
access to evidence-based psychological therapies for these
problems; that programme has now been used by more than a million
In 1996, Professors Anthony Roth and Peter Fonagy from UCL
co-authored What Works For Whom? A critical review of psychotherapy
research. The book became a cornerstone for global policy and
practice in psychological therapy. A second edition was published
in 2005 and in 2002, Fonagy published What Works For Whom? A
critical review of treatments for children and adolescents ,
expanding into the evidence for the full range of child and
adolescent mental health treatments.
What Works For Whom? represented the first systematic and
comprehensive review of all quantitative studies of the efficiency
of psychological therapy over the major diagnostic categories of
mental health disorder. It quickly become a standard reference and
teaching text for psychological therapy, for postgraduate training
programmes and academic courses around the globe and had a
significant influence on clinical practice.
In 2008 the UK government launched the Improving Access to
Psychological Therapies (IAPT) programme. The goal of the programme
was to ensure faster access to evidence-based psychological
therapies for depression and anxiety in adults. The push for the
programme’s development was underpinned specifically by evidence in
What Works For Whom?
Since its inception, the IAPT programme has increased funding
for psychological services from £161 million in 2007-8 to £389
million in 2011-12. The availability of therapists, and the number
being trained, has increased and they have been trained in specific
techniques for which there is evidence of efficacy.
By the end of its first full three years more than 1 million
people had used the new IAPT services; recovery rates were in
excess of 45% and more than 45,000 people had moved off benefits.
Along with its impacts on individual patient well-being, IAPT has
delivered significant economic gains via NHS savings, reduced
welfare spending, and increased return to the workforce.
In 2011 IAPT was expanded to include children and adolescents.
Professor Fonagy was the National Clinical Lead, overseeing a
four-year, £8 million/year investment. In 2012, ministers agreed to
additional investment for 3 years, and in 2013 to extend the
programme to 24 new sites, with services covering 54% of 0-19 year
olds in England by the end of 2013.
By comprehensively demonstrating and espousing the principles of
evidence-based practice, What Works For Whom? has helped cement the
commitment to evidence-based practice which is now an underlying
principle for almost all UK professional training in psychological