Long-term conditions and medically-unexplained symptoms: feasibility of cognitive behavioural interventions within the improving access to Psychological Therapies Programme

J Ment Health. 2015 Dec;24(6):379-84. doi: 10.3109/09638237.2015.1022254. Epub 2015 Sep 11.

Abstract

Background: Improving access to psychological therapies (IAPT) is a major programme in England to treat common mental health problems, mainly through cognitive behaviour therapy. In 2012, a Pathfinder scheme was launched to develop interventions for people with chronic physical health conditions or medically-unexplained symptoms.

Aim: This qualitative component of the evaluation investigated feasibility and acceptability of IAPT provision for people with enduring physical health problems.

Method: Qualitative interviews were conducted with project leaders in all 14 Pathfinder sites.

Findings: Various therapeutic and training interventions were introduced. Most patients received low-intensity, structured therapy, with high-intensity input provided by some Pathfinders for complex cases. Whether the focus was on psychological symptoms or on broader well-being, psychiatric terminology was avoided to improve utilisation. Participants perceived high satisfaction among service-users. Training needs were indicated for IAPT workers in this specialised work.

Conclusions: Cognitive behaviour interventions appeared to be acceptable for people struggling with physical health problems. Robust outcome evidence will be pursued in Phase II.

Keywords: Behaviour therapy; medically-unexplained symptoms; physical health conditions.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Anxiety / prevention & control
  • Chronic Disease / prevention & control*
  • Cognitive Behavioral Therapy* / education
  • Depression / prevention & control
  • Feasibility Studies
  • Health Services Accessibility
  • Humans
  • Mental Health Services / standards*
  • Mental Health Services / statistics & numerical data
  • Patient Satisfaction
  • Qualitative Research
  • Treatment Outcome