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The Royal College of Psychiatrists Improving the lives of people with mental illness

The Science of Psychiatry: Making an Impact


This piece of research was taken from 'Research and psychiatry - making an impact'

The evidence behind psychological therapies

Type of research
Depression, schizophrenia
Impact on
Therapy type

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 people.

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 therapy.

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