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Telephone delivery of psychological interventions: balancing protocol with patient-centred care

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Paul Drew, Annie Irvine, Michael Barkham, Cintia L Faija, Judith Gellatly, Kerry Ardern, Christopher J Armitage, Helen Brooks, Kelly Rushton, Charlotte Welsh, Peter Bower, Penny Bee

Original languageEnglish
Article number113818
Pages (from-to)113818
Number of pages1
JournalSocial Science & Medicine
Volume277
DOIs
Accepted/In press3 Mar 2021
Published1 May 2021

Bibliographical note

Funding Information: This study is funded by the UK's NIHR Programme Grants for Applied Research (grant reference number: RP-PG-1016-20010). The views expressed are those of the authors and not necessarily those of the NIHR or the Department of Health and Social Care. The funders had no role in study design, data collection, analysis or interpretation, decision to publish, or preparation of the manuscript. We gratefully acknowledge the contribution of the patients and PWPs who agreed to allow us to record their conversations. Armitage is supported by the NIHR Manchester Biomedical Research Centre and NIHR Greater Manchester Patient Safety Translational Research Centre. Funding Information: This study is funded by the UK's NIHR Programme Grants for Applied Research (grant reference number: RP-PG-1016-20010 ). The views expressed are those of the authors and not necessarily those of the NIHR or the Department of Health and Social Care. The funders had no role in study design, data collection, analysis or interpretation, decision to publish, or preparation of the manuscript. We gratefully acknowledge the contribution of the patients and PWPs who agreed to allow us to record their conversations. Armitage is supported by the NIHR Manchester Biomedical Research Centre and NIHR Greater Manchester Patient Safety Translational Research Centre. Publisher Copyright: © 2021 Copyright: Copyright 2021 Elsevier B.V., All rights reserved.

King's Authors

Abstract

Common mental health problems of anxiety and depression affect significant proportions of the global population. Within the UK, and increasingly across western countries, a key policy response has been the introduction of high volume, low intensity psychological assessment and treatment services, such as the NHS's Improving Access to Psychological Therapies (IAPT) service, the largest service delivery model yet to be implemented at a national level (England). IAPT may be delivered in face-to-face meetings or over the telephone, as well as through other media. In order to increase access and achieve wide reach with efficient use of resources, IAPT's service models utilise relatively structured and standardised protocols, whilst aiming simultaneously to deliver a tailored and personalised experience for patients. Previous research has revealed that this can be a challenging balance for front-line practitioners to strike. Here we report research into the telephone delivery of guided self-help, low intensity interventions within IAPT, examining the challenges faced in remote delivery when combining structure with personalisation during assessment and treatment sessions. We show the ways in which the lack of flexibility in adhering to a system-driven structure can displace, defer or disrupt the emergence of the patient's story, thereby compromising the personalisation and responsiveness of the service. Our study contributes new insights to our understanding of the association between personalisation, engagement and patient experience within high volume, low-intensity psychological treatment services. Our research on the telephone delivery of IAPT is particularly timely in view of the current global Covid-19 health crisis, as a result of which face-to-face delivery of IAPT has had to be (temporarily) suspended.

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