David M Clark

Research Summary

My research mainly focuses on cognitive approaches to the understanding and treatment of anxiety disorders. My team uses a closely integrated programme of experimental and clinical studies. The general strategy has been to: (i) use clinical interviews and cognitive psychology paradigms to identify the core cognitive abnormality in an anxiety disorder; (ii) to construct a theoretical account which explains why the cognitive abnormality does not self-correct; (iii) test the hypothesised maintaining factors in rigorous experimental studies; (iv) develop specialised cognitive treatments which aim to reverse the maintaining factors; (v) test the efficacy of the treatments in randomised controlled trials.

The research has led to the development of new and effective cognitive therapy programmes for three different anxiety disorders: panic disorder, social phobia and posttraumatic stress disorder, each of which are recommended first line treatment options in current NICE guidelines. 

A further strand of my research has focused on how to disseminate the new treatments so they can be made available to as many people as possible. The first major dissemination project focussed on training clinicians in cognitive therapy for PTSD in order to provide effective treatment services for victims of bombs in Omagh and London. The second project is the English Improving Access to Psychological Therapies (IAPT) programme that has trained over 10,000 new psychological therapists and deployed them in specialist psychological therapy services for anxiety disorders and depression. The clinical outcomes of everyone who receives a course of therapy are recorded using a unique session by session outcome monitoring system. The overall outcomes achieved by each IAPT service and their breakdown by a wide range of patient and demographic characteristics are publicly reported. Analyses of outcome variation have been used to identify optimal ways of delivering therapy and have facilitated service improvements. I have been involved with the programme since its inception and am currently the National Clinical and Informatics Advisor.  A third project involves developing and evaluating internet versions of the treatments.

A broad overview of my work can be found in Layard & Clark's (2014) Thrive (Penguin).