Therapists’ perceptions of barriers and facilitators to uptake and engagement with therapy in long-term conditions

Susan Carroll; Rona Moss-Morris; Katrin Hulme; Joanna Hudson

doi:10.1111/bjhp.12475

Therapists’ perceptions of barriers and facilitators to uptake and engagement with therapy in long-term conditions

Susan Carroll, Rona Moss-Morris, Katrin Hulme, Joanna Hudson^*

^*Corresponding author for this work

Research output: Contribution to journal › Article › peer-review

16 Citations (Scopus)

Abstract

Objective: Improving Access to Psychological Therapies (IAPT) services in England have established a long-term condition (LTC) pathway in recent years, meaning that LTC therapies are now delivered via varied modes and by professionals with varied experiences. To gain insight into how this new pathway is functioning in practice, this study aimed to explore therapists’ perceptions of barriers and facilitators to uptake and engagement with therapy in LTCs. Design: A qualitative design was employed using semi-structured interviews. Methods: Fifteen therapists were recruited from IAPT and physical health care settings. Interviews were first analysed using inductive thematic analysis. A deductive approach was then taken to map themes onto Normalisation Process Theory constructs (coherence, cognitive participation, collective action, reflective monitoring) to guide steps towards improving implementation. Results: Four key themes highlighted patient, therapist, and service-level factors related to uptake and engagement: Working flexibly with barriers within the National Health Service context; Acceptability of ‘embedded’ versus ‘separate’ psychological care; Confidence in working with people with LTCs; and Navigating implementation of online therapies. Therapists recognized the need for tailored LTC therapies, though opinions about online therapies varied. Therapists expressed commitment to flexibly adapting their practice to suit patient needs, but felt their flexibility was limited by system and service constraints. Conclusion: Barriers to uptake and engagement need to be addressed to optimize LTC pathways. Findings demonstrated the importance of offering flexible, tailored therapy to people with LTCs, and equipping staff and services with adequate training and resources to improve functioning of LTC pathways in practice.

Original language	English
Journal	British Journal of Health Psychology
DOIs	https://doi.org/10.1111/bjhp.12475
Publication status	Accepted/In press - 1 Jan 2020

Keywords

cognitive behavioural therapy
Improving Access to Psychological Therapies
long-term conditions
online therapy
psychological therapy
qualitative

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10.1111/bjhp.12475

Cite this

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abstract = "Objective: Improving Access to Psychological Therapies (IAPT) services in England have established a long-term condition (LTC) pathway in recent years, meaning that LTC therapies are now delivered via varied modes and by professionals with varied experiences. To gain insight into how this new pathway is functioning in practice, this study aimed to explore therapists{\textquoteright} perceptions of barriers and facilitators to uptake and engagement with therapy in LTCs. Design: A qualitative design was employed using semi-structured interviews. Methods: Fifteen therapists were recruited from IAPT and physical health care settings. Interviews were first analysed using inductive thematic analysis. A deductive approach was then taken to map themes onto Normalisation Process Theory constructs (coherence, cognitive participation, collective action, reflective monitoring) to guide steps towards improving implementation. Results: Four key themes highlighted patient, therapist, and service-level factors related to uptake and engagement: Working flexibly with barriers within the National Health Service context; Acceptability of {\textquoteleft}embedded{\textquoteright} versus {\textquoteleft}separate{\textquoteright} psychological care; Confidence in working with people with LTCs; and Navigating implementation of online therapies. Therapists recognized the need for tailored LTC therapies, though opinions about online therapies varied. Therapists expressed commitment to flexibly adapting their practice to suit patient needs, but felt their flexibility was limited by system and service constraints. Conclusion: Barriers to uptake and engagement need to be addressed to optimize LTC pathways. Findings demonstrated the importance of offering flexible, tailored therapy to people with LTCs, and equipping staff and services with adequate training and resources to improve functioning of LTC pathways in practice.",

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Therapists’ perceptions of barriers and facilitators to uptake and engagement with therapy in long-term conditions

Abstract

Keywords

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