Contending with the minimum data set: Subjectivity, linearity and dividualising experiences in Improving Access to Psychological Therapies

Health (London). 2020 Jan;24(1):94-109. doi: 10.1177/1363459318785718. Epub 2018 Jul 10.

Abstract

Improving Access to Psychological Therapies has lead to a huge increase in the delivery of psychological therapy within the United Kingdom over the past 10 years. Central to the culture of Improving Access to Psychological Therapies is outcome monitoring, brought into every therapeutic encounter through the compulsory collection of the minimum data set in each session. This article explores the role of compulsory outcome monitoring in service users' experiences of using Improving Access to Psychological Therapies, with a focus on how these forms are folded into distress, therapy and recovery. Data from a small-scale qualitative study are drawn upon. Thematic analysis was conducted on multimodal interviews with current service users. The article explores the ways in which the minimum data set acted as a 'quasi object', exploring three main roles of the minimum data set: as an authorising mediator, an alienating adversary and a deferring gatekeeper. Pictures of therapeutic progress, as presented via outcome measures, often ran counter to users' reported experience of distress. We conclude that far from being a neutral and objective assessment tool, the minimum data set functions as a living actant in the therapeutic encounter.

Keywords: Deleuze; Improving Access to Psychological Therapies (IAPT); Latour; Mental health; experiencing illness narratives; health policy; mental distress; non-linear.

MeSH terms

  • Anxiety / therapy
  • Cognitive Behavioral Therapy*
  • Datasets as Topic*
  • Depression / therapy
  • Female
  • Health Services Accessibility*
  • Humans
  • Male
  • Mental Disorders / therapy*
  • Narration
  • Outcome Assessment, Health Care*
  • Qualitative Research
  • United Kingdom