Search results

Despite the emergence of NICE guidelines regarding the effectiveness and appropriateness of psychological therapies for the majority of common mental health problems, access to these services is still dramatically underdeveloped and uneven. Estimates of untreated problems such as depression and anxiety in primary care signal the extent of these problems and the scale of investment in new services, if these needs are to be adequately met in the future.The Department of Health's and the Care Services Improvement Partnership's (CSIP) Improving Access to Psychological Therapies (IAPT) programme sets out a framework and a series of co‐ordinated actions, including two national demonstration sites, to begin to address these issues in England.This paper examines the origins and policy drivers that have given rise to the IAPT programme, outlines the progress to date and specifically assesses the implications for the mental health workforce of this programme. Issues addressed include the workforce profiles of existing services, career frameworks for psychological therapists, the capacity of training providers to train new and existing staff in psychological therapies and the challenges implicit in devising a workforce delivery plan to support the IAPT programme.

The purpose of this paper is to identify and report on the mental health needs of those attending substance misuse services (SMS) adhering to the diagnostic criteria as defined in DSM 5 with reference to common mental health disorders. It also examines differences in the numbers of appropriately trained cognitive behaviour therapy (CBT) therapists and highlights the lack of provision of CBT reflected in the much smaller number of accredited therapists in Wales compared to other parts of the UK.

This population was identified by way of an audit of data collected via the out-patient clinics conducted by the author.

The paper identifies a high proportion of patients who attended SMSs as having complex psychological need as a consequence of co-morbidity.

The results of the audit may have limitations but the implications from the findings suggest potential value in looking more at clinical outcomes following evidence-based psychological interventions.

A conclusion from the findings is suggested value in a more structured approach to looking at clinical outcomes.

This audit was undertaken in North Wales. There is no IAPT or matrix-structured Level II CBT training programmes available in Wales. The audit identifies the need for more evidence-based psychological interventions such as CBT linked to the development of such services. The apparent lack of political will to change the status quo is also highlighted as a problem.

The purpose of this paper is to explore how the use of self‐help bibliotherapy developed from a local pilot scheme to become national policy in Wales. Analysis aims to focus on the use of evidence‐based practice (EBP) as a justification in the process of policy creation.

A mixed methodological approach was used to gather data, incorporating semi‐structured interviews, documents, and descriptive statistics. Actor‐network theory (ANT) was used as a critical lens to frame analysis.

The study finds that the translation from local pilot to national initiative was achieved using legitimising discourses including EBP. These discourses were used selectively, and in response to the needs of the focal actors in the network. The complex relationship between EBP and self‐help bibliotherapy is explored in connection with healthcare policy, concluding that the use of EBP legitimises a lack of patient‐centred evaluation.

Limitations of the research include a lack of engagement with patients using the scheme, and future research should aim to present a more patient‐centred account to complement this policy‐focused work.

Little in‐depth work has been conducted on the strategy behind the introduction of bibliotherapy schemes in the UK or elsewhere, and this paper presents an in‐depth theoretical analysis of the first nationwide bibliotherapy scheme in the world.

This paper's aim is to explore the added value of occupational therapy in supported employment, demonstrated by a case study in Sussex Partnership NHS Foundation Trust.

The paper sets out the unique contribution of occupational therapy to the evidence based individual placement with support (IPS) model, through a case study of implementation in Sussex.

Occupational therapists are well placed to play a central role in embedding IPS into clinical teams, as well as supporting the work of employment specialists. They also have a wider role in championing person centred practice, and challenging negative assumptions about the work abilities of people with mental health problems.

Clarity of role design is crucial, with methods for assessing and monitoring competence built into supervision structures. Clinicians need to be motivated and enthusiastic about the role as well as having allocated time to carry out the discrete employment support function. The partnership between the employment service and clinical team is central to good implementation of the model.

This paper adds clarity to the role of occupational therapy in supporting people with severe and enduring mental health problems to gain and maintain mainstream employment. There is a need for the development of a more formal evidence base for occupational therapy interventions in the field of supported employment; this paper is a starting point outlining key issues.

Leadership is a critical topic in healthcare because of its influence on direction and culture. This study aims to measure perceptions of leadership styles amongst occupational therapy clinicians. The study also sought to identify any significant differences between the perceptions of clinician groups, compare findings with established norms and explore associations between leadership styles and outcomes.

A cross sectional, descriptive study method was used, using the multifactor leadership questionnaire 5X (MLQ-5X) to survey occupational therapists working in physical and mental health clinical services in Australia. Descriptive statistics were used to address the aims of this study.

A number of significant differences in leadership perceptions were identified between junior and senior clinicians, however, very few differences were detected between the physical and mental health settings. The scores provided by participants were consistently lower than those reported for geographically relevant norms, with the majority on or close to the 40th percentile. A significant relationship was found between transformative leadership and outcomes, and a strong relationship between contingent reward and outcomes. However, the negative relationships between other leadership styles and outcomes reported in other studies were not found.

Transformational leadership, and some aspects of transactional leadership, are used in occupational therapy. The career stage has an impact on how leadership behaviours are perceived. The MLQ-5X could enable a consistent approach to research into healthcare leadership, and the exploration of whether these findings are generalisable beyond the Australian context.

Career stage may be a more significant influence on leadership perception than service setting, and efforts to develop leadership in occupational therapy should focus on both transformative and transactional leadership. Perceptions of occupational leadership from all areas of the workforce are important to understand, given their potential impact on workplace behaviour, career progression, recruitment and retention.

This study is a partial replication of a previous study conducted in the USA, being the first to use the MLQ-5X with the Australian occupational therapy workforce. As such, it consolidates the existing evidence base in this area and also enables international comparisons of findings.

This article reports the evaluation of two workshops to develop evidence‐based practice (EBP) in occupational therapy and physiotherapy. An innovative approach was taken in the design of workshops on critical appraisal which specifically addressed needs of therapists to appraise clinical effectiveness (ACE). The background to the workshops is given and the evaluative process and a summary of the findings presented. The statistical analysis indicates that there is a significant difference (P= 0.0001) in self‐reported knowledge before and after the workshops. The evaluation highlights the differing needs of health care professional groups in establishing a culture of EBP in then‐workplaces.

The purpose of this paper is to describe the views and experiences of Improving Access to Psychological Therapies (IAPT) practitioners in providing therapy to patients who have an intellectual disability in order to support IAPT services in increasing their capability in this area.

An online survey was conducted of IAPT practitioners in four IAPT services in the north of England. The survey collected respondents demographic information and their experience, confidence and attitudes to working with people with intellectual disabilities. Qualitative responses regarding respondents attitudes, views of barriers, problems, successes and possible solutions to the delivery of therapy to people with intellectual disabilities within IAPT services were collected. The survey results were interpreted by thematic and statistical analysis.

The majority of respondents report having worked with people with intellectual disabilities and identify the need to adapt therapy, but also believe that such therapy should be offered within mainstream services. Thematic analysis identifies the needs for support in training, therapy adaptation and adjustment to pathways. However, the majority of respondents could identify positive outcomes and experiences.

This data supports the further development of pathways and offers some broad frameworks for the focus of training and development work for people with intellectual disabilities within IAPT.

This project has identified a positive attitude and willingness to consider adaptation of therapy for people with intellectual disabilities in practitioners working within IAPT services.

Until now the views and experiences of IAPT practitioners in working with this patient group were relatively unknown.

Occupational therapists working in mental health services in the UK are under increasing scrutiny to provide both clinically and cost-effective services. The profession has indicated that a stronger evidence base would help promote the unique contribution of occupational therapy when influencing service managers and government bodies. The paper aims to discuss these issues.

The Royal College of Occupational Therapists (RCOT) and its Specialist Section – Mental Health carried out a survey to gauge recent research capacity among occupational therapists working in mental health services in the UK and to seek their views about how to further increase research capacity and partnerships.

Of the 145 participants approximately half had been involved in research in the past five years, and most had involved research partnerships. A number had successfully applied for funding and about half of the research carried out had been disseminated. The participants felt that methods to increase research capacity and partnerships should continue to include improving research leadership and networks; promoting research skills through formal studies and increasing research dissemination.

A variety of methods will continue to be required to expand the evidence base. RCOT and its Specialist Sections continue to have an important role developing research capacity and partnerships.