title: Service use, drop-out rate and clinical outcomes: a comparison between high and low intensity treatments in an IAPT service.
abstract: BACKGROUND
  The IAPT services provide high and low intensity psychological treatments for adults suffering from depression and anxiety disorders using a stepped care model. The latest national evaluation study reported an average recovery rate of 42%. However, this figure varied widely between services, with better outcomes associated with higher "step-up" rates between low and high intensity treatments.
  
  
  OBJECTIVE
  This study aimed to compare the two intensity groups in an IAPT service in Suffolk.
  
  
  METHODS
  This study adopted a between groups design. A sample of 100 service users was randomly selected from the data collected from an IAPT service in Suffolk between May 2008 and February 2011. The treatment outcomes, drop-out rate, and other characteristics were compared between those who received high and low intensity treatments.
  
  
  RESULTS
  The high intensity group received, on average, more sessions and contact time. They received more CBT sessions and less guided self-help. There were no group differences in terms of the drop-out and appointment cancellation rates. Analyses on clinical outcomes suggested no group difference but demonstrated an overall recovery rate of 52.6% and significant reduction in both depression and anxiety symptoms.
  
  
  CONCLUSIONS
  Despite methodological limitations, this study concludes that the service as a whole achieved above-average clinical outcomes. Further research building upon the current study in unpacking the relative strengths and weaknesses for the high and low intensity treatments would be beneficial for service delivery.
authors.affiliation: University of East Anglia,NorwichandUniversity of Edinburgh,UK.
authors.forename: Stella W Y
authors.initials: SW
authors.lastname: Chan
authors.affiliation: University of East Anglia,Norwich,UK.
authors.forename: Malcolm
authors.initials: M
authors.lastname: Adams
mesh_terms: D000328:Adult; D001008:Anxiety Disorders / Q000453:epidemiology* / Q000523:psychology / Q000628:therapy*; D015928:Cognitive Behavioral Therapy / Q000379:methods* / Q000706:statistics & numerical data*; D003153:Community Health Services / Q000706:statistics & numerical data*; D003866:Depressive Disorder / Q000453:epidemiology* / Q000523:psychology / Q000628:therapy*; D005260:Female; D006297:Health Services Accessibility / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008875:Middle Aged; D009042:Motivation; D010352:Patient Dropouts / Q000523:psychology* / Q000706:statistics & numerical data*; D012648:Self Care / Q000379:methods / Q000706:statistics & numerical data; D011795:Surveys and Questionnaires; D014600:Utilization Review; D055815:Young Adult