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What it means to be an Ieso therapist

Ieso strives to enable therapists to be the best therapists they can be! I’d like to tell you a little more about why and how we do this.

The last decade has seen a growing body of evidence that demonstrates that some computer and internet based interventions can be effective for the treatment of common mental health problems (Hedman, Ljottson and Lindefors, 2012). Whilst there is an evidence base to support the use of a range of technological applications of CBT, it is apparent that that not all methods apply rigorous controls in relation to the selection of high quality clinicians, provision of data led continuing professional development and outcomes based performance monitoring and management as we do at Ieso.

There is still a shortage of suitably qualified and experienced CBT therapists who are able to deliver CBT with fidelity to the model and adhere to the evidence base (Ludgate 2016). However, we understand that an expert clinician is intuitive and possesses an authoritative knowledge base that enables them to practice flexibly and reflexively at a high level. In light of the evidence that supports the utilisation of highly skilled regulated and governed clinicians, Ieso Digital Health recruits clinicians who are accredited by the British Association of Behavioural and Cognitive Psychotherapy (BABCP). We are also working with universities who run accredited post-graduate training programmes and enable closely supervised trainees to learn to work effectively online. We know through our own research at Ieso that one of the greatest predictors of clinical recovery and improvement in relation to patient outcomes is linked to therapist variables and methods of interventions. Better outcomes are achieved when services use experienced therapists who adhere to the National Institute of Health and Care Excellence (NICE) guidelines for the treatment of depression and anxiety disorders (Gyani, Shafran, Layard and Clark, 2013).

We work to ensure:

  • Only the most competent and clinically effective therapists are selected to deliver CBT with Ieso services.
  • That a unique blend of technological and clinical processes are employed to support and enable therapists to provide gold standard treatments.
  • That clinical data is used to support and enable therapists to provide better outcomes.

Recruiting competent therapists who can provide high quality interventions is the first stage in the process. Initially therapists are selected based on the criteria defined above and whilst these therapists are both highly skilled and highly qualified, not all will go on to provide the most effective online cognitive behavioural therapy.

What we know from the research is that therapist competence and behaviours correlate directly with patient outcomes (Branson, Shafran and Myles, 2015). Ieso Digital Health has been able to further develop this assertion by understanding more about the qualities of therapists as they begin to work online for the first time.

The most effective therapists that work well online with Ieso:

  • Are evidence-based practitioners
  • Are professional
  • Achieve good clinical outcomes
  • Demonstrate fidelity to the CBT model/protocols
  • Have an excellent interpersonal style
  • Show flexibility and the ability to reflect (in action and on action)
  • Develop excellent written communication skills
  • Are scientist practitioners

All qualified and accredited therapists are required to undertake a probationary period. During this period their ability to deliver CBT with fidelity to the model, their adherence to the evidence-base and the therapist qualities outlined are all closely assessed.

Ieso Digital Health has learnt how therapists can drift from the evidence base at a variety of stages of assessment and treatment. Therapist drift is closely associated with poorer outcomes (Waller and Turner 2016). This conjecture has been substantiated following extensive research and empirical data. Given that there is a significant correlation between therapist drift and clinical outcomes it follows that supporting and enabling therapists to adhere to the evidence base and demonstrate the therapist qualities we are looking for will lead to improved outcomes for patients.

A system of ongoing monitoring and support aids are available including: clinical supervision, dedicated case management systems and the therapist portal. In 2017/18 further exciting and innovative developments will be introduced. These include a therapist forum, routine sharing of therapist data, e-learning CPD modules and online workshops to name but a few. This ongoing and reflective package of support is to ensure that those therapists who have recently joined us and those who been working with us for some time, develop and maintain the same high quality standards and clinical outcomes expected.

On the rare occasions when therapists are unable to demonstrate the qualities and standards outlined above to adapt successfully to working online, this is communicated to the individual therapist. In many situations, an idiosyncratic training programme and development plan is agreed. However, therapists who consistently demonstrate difficulties and/or poor evidence of the clinical outcomes, knowledge, skills and professional attitudes we require will no longer be used by the service.

The systems, processes and support we offer at Ieso inform and facilitate a cycle of continuous improvement that is novel and innovative. Ieso has built a reputation amongst the CBT therapist community in the UK as being a service that enables therapists to become the best they possibly can. Regardless of their level of experience; newly qualified or with years of experience, therapists are attracted to working with Ieso because of the innovation, quality of support and continued professional development they receive.

Be the best therapist you can be. Be an Ieso therapist.

Stephen Freer

UK Clinical Lead, Ieso Digital Health

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