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Recent NHS policy has prioritised improving access to cost-effective psychological interventions for people with mental health problems. Research by Lucock at the Centre for Health and Social Care Research (CHSCR) has contributed to meeting this challenge by developing and evaluating self-help interventions which can be provided by a range of NHS staff without professional psychotherapy or mental health training. This work has resulted in the creation of the Self-Help Access in Routine Primary Care (SHARP) initiative, a programme that gives practitioners materials and training which enable them to deliver brief self-help interventions supported by a dedicated website and a range of leaflets that recognise service users' need for easy-to-understand material. Feedback from practitioners on the website and training has been positive. There is evidence of positive impacts of the training on practitioners' confidence in their ability to deal with anxiety and depression, and in greater use of Cognitive Behaviour Therapy (CBT) approaches with patients. Evidence from testimony demonstrates impact on practice. Research also provides evidence of benefit to patients in terms of reduction of anxiety and depression and goal attainment. The research has also influenced national guidance on best practice.
This case study describes the impact generated by Dr Paul Flaxman's research in the Department of Psychology at City University London. Flaxman has taken a prominent role in designing a psychological skills training programme that is based on recent developments in the field of psychotherapy. The training has been adopted and utilised by a range of organisations, including Northumbria Healthcare Trust; Central Manchester Foundation Trust; Camden and Islington NHS Foundation Trust; and the South London and Maudsley Mental Health Trust. Other beneficiaries include the City and Hackney branch of Mind (the mental health charity) and nurse training providers at Middlesex University. International reach is evidenced by the adoption of the training for supporting psychiatric nurses working in Uganda. Data collected from over 600 British employees indicate that the training leads to significant and sustained improvements in people's mental health. The training has been shown to be particularly beneficial for employees experiencing a common mental health problem such as anxiety or depression.
Our research has had a direct influence on policy makers', commissioners' and practitioners' understanding of the value of peer led self-help groups and the potential of citizen/service user researchers for driving service improvements grounded in lived experience. That impact is reflected in:
Research into the process and efficacy of structured peer group supervision (PGS) for trainee and practicing psychologists, led by Akhurst at York St John University, collaborating with partners at the University of Leeds, has impacted on a number of psychology training programmes. The PGS model is also being adopted by various health practitioners to complement individual supervision. The model has been implemented variously in the Republic of Ireland, South Africa and the UK. Optimising use of the internet as a means for materials dissemination has enabled the DVD created by the research team to be used widely in professional development.
An estimated one in four people in the UK will experience depression or anxiety at some point in their lives. Cognitive behavioural therapy (CBT) is the most widely recommended non-medication- based treatment for common mental health problems, although access to this treatment is limited because of low numbers of expert practitioners. Self-help CBT resources developed by researchers at the University of Glasgow have been integrated into routine clinical practice delivered by health services and the voluntary sector in the UK, Ireland and Canada. Since 2008, these practical user-friendly resources have provided support to over 200,000 users online and an estimated 250,000 people on a one-to-one basis or within a class.
The pioneering work undertaken at UCL has had a major impact on clinical practice for the treatment of self-harming, suicidal patients with a diagnosis of borderline personality disorder and the techniques have been drawn on in extensions to other common mental disorders including eating disorder, substance misuse, and antisocial personality disorder. This treatment, known as mentalisation based therapy or MBT, has since been applied in a range of clinical settings including inpatient and outpatient work in the UK and internationally. This case study presents two areas in particular where our research has been applied: the treatment of personality disorders, and in work with troubled adolescents.