Contending with the Minimum Data Set: Subjectivity, linearity and dividualising experiences in Improving Access to Psychological Therapy

Improving Access to Psychological Therapy (IAPT) has lead to a huge increase in the delivery of psychological therapy within the UK over the past ten years. Central to the culture of IAPT is outcome monitoring, brought into every therapeutic encounter through the compulsory collection of the minimum data set in each session (MDS). This paper explores the role of compulsory outcome monitoring in service users’ experiences of using IAPT, with a focus on how these forms are folded into distress, therapy and recovery. Data from a small scale qualitative study are drawn upon. A process orientated thematic decomposition analysis was conducted on multimodal interviews with current service users. The paper explores the ways in which the MDS acted as a ‘quasi object’, exploring three main roles of the MDS: 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 MDS functions as a living actant in the therapeutic encounter.