The initial design and programme theory for a new work-focused psychotherapeutic intervention to treat moderate-severe recurrent depression and enhance job retention
ISSN: 1361-9322
Article publication date: 3 May 2022
Issue publication date: 9 November 2022
Abstract
Purpose
Here, this study aims to report a case study of the initial design and programme theory of an interdisciplinary work-focused relational group cognitive behaviour therapy (CBT) treatment programme for moderate-severe depression using realist methods.
Design/methodology/approach
This case study shows how the authors designed the intervention using component analysis of existing literature and focus groups of frontline practitioners and former service users and mind-mapping analysis to establish its operational logic and evaluated the theory underpinning the intervention using realist synthesis and evaluation to establish its conceptual logic.
Findings
An iterative hybrid approach of literature review, component analysis, focus group discussion and realist methods established the initial design and programme theory for the new intervention. The intervention focused on three areas of therapy, three inter-dependent outcomes, in a group format, with opportunities created for peer interaction. The main theoretical principles most likely to promote efficacy were to accelerate and optimise activation of one or more of six hypothesised mechanisms: realise, reflect, regulate, resolve, relate and retain/resume in the context of skilfully facilitated group psychotherapy.
Social implications
This study outlines a methodological approach based on the layered ontology of critical realist philosophy, applied to a successful example, which will be useful during the early stages of the design and development of new group-based psychotherapeutic interventions.
Originality/value
By adopting the critical realist approach, the authors identified underlying mechanisms of change in relational group CBT. The theoretically integrated approach involving service users and practitioners from different professional backgrounds was unique and meant that the treatment programme was multi-modal rather than informed by a single therapeutic or theoretical approach.
Keywords
Acknowledgements
Special thanks to Associate Professor Michael Townend and Dr Helen Stoneley (University of Derby), who supervised the study, and to the participants who agreed to take part.
Research ethics: NHS LREC Ref: 12/YH/0303 approval granted 30.05.2012.
Declaration of conflicting interests: The authors confirm that there is no conflict of interest.
Statement of contributorship: NW researched literature and conceived the study. SH was involved in practitioner focus groups and protocol development. NW wrote the first draft of the manuscript. Both authors reviewed and edited the manuscript and approved the final version of the manuscript.
Funding: This research received no specific grant from any funding agency in the public, commercial or not-for-profit sectors.
Citation
Walker, N. and Hall, S. (2022), "The initial design and programme theory for a new work-focused psychotherapeutic intervention to treat moderate-severe recurrent depression and enhance job retention", Mental Health Review Journal, Vol. 27 No. 4, pp. 372-397. https://doi.org/10.1108/MHRJ-12-2020-0094
Publisher
:Emerald Publishing Limited
Copyright © 2022, Emerald Publishing Limited