Exploring the implementation of cognitive behaviour therapy for psychosis using the Normalization Process Theory framework

Xanidis, N. and Gumley, A. (2019) Exploring the implementation of cognitive behaviour therapy for psychosis using the Normalization Process Theory framework. Psychology and Psychotherapy: Theory, Research and Practice, (doi:10.1111/papt.12217) (PMID:30672074) (Early Online Publication)

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Abstract

Objective: Evidence suggests that only a minority of service users experiencing psychosis have access to Cognitive Behavioural Therapy for psychosis (CBTp). Normalisation Process Theory (NPT) is a theoretical framework which focuses on processes by which interventions are implemented and normalised in clinical practice. This study explored the views and experiences of mental health professionals regarding the implementation of CBTp. Barriers and facilitators to implementation were explored using the NPT framework. Design: A qualitative methodology was adopted involving semi-structured focus groups and individual interviews. Methods: A total of 14 members of staff working in the community and crisis mental health teams were recruited. Thematic analysis was used to generate initial themes. The Framework approach was utilised to map initial themes to the NPT framework. Results: Inductive coding generated five overarching themes consisting of 15 individual subthemes which captured the perceived barriers to engagement; contextual barriers to implementation; optimisation of implementation; positive attitudes towards implementation; and expectations of implementing CBTp. All but two subthemes mapped on to the NPT framework. The deductive analysis suggested that difficulties in making sense of CBTp among professionals were reflected as service level barriers which impeded wider implementation. Conclusion: The results of this study suggested a mixture of barriers and facilitators to CBTp implementation. Interpreting our findings within an NPT framework indicates the importance of strong clinical leadership to address difficulties in sense-making and service investment in CBTp.

Item Type:Articles
Status:Early Online Publication
Refereed:Yes
Glasgow Author(s) Enlighten ID:Gumley, Professor Andrew and Xanidis, Nikos
Authors: Xanidis, N., and Gumley, A.
College/School:College of Medical Veterinary and Life Sciences
College of Medical Veterinary and Life Sciences > Institute of Health and Wellbeing > General Practice and Primary Care
Journal Name:Psychology and Psychotherapy: Theory, Research and Practice
Publisher:Wiley
ISSN:1476-0835
ISSN (Online):2044-8341
Published Online:22 January 2019
Copyright Holders:Copyright © 2019 The British Psychological Society
First Published:First published in Psychology and Psychotherapy: Theory, Research and Practice 2019
Publisher Policy:Reproduced in accordance with the copyright policy of the publisher

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