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

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.