A Qualitative Study of Patients' Perceptions of a ‘Minimal’ Psychological Therapy

• Published in: International journal of social psychiatry Vol. 53; no. 1; pp. 23 - 35
• Main Authors: Macdonald, Wendy, Mead, Nicola, Bower, Peter, Richards, David, Lovell, Karina
• Format: Journal Article
• Language: English
• Published: London, Los Angeles, New Delhi and Singapore SAGE Publications 01.01.2007; Sage; Sage Publications Ltd
• Subjects: Access; Adult; Biological and medical sciences; Communication; Depressive Disorder - psychology; Depressive Disorder - therapy; England; Experts; Female; Health problems; Humans; Internship, Nonmedical; Intervention; Interview, Psychological; Male; Manuals as Topic; Medical sciences; Mental disorders; Mental health; Mental illness; Middle Aged; Minimal access therapy; Miscellaneous; Negotiation; Patient communication; Patient Education as Topic; Patient Satisfaction; Patients; Perception; Professional-Patient Relations; Psychological services; Psychology. Psychoanalysis. Psychiatry; Psychopathology. Psychiatry; Psychotherapies. Psychological and clinical counseling; Psychotherapy; Psychotherapy, Brief - education; Qualitative analysis; Qualitative research; Self Care - psychology; Self help; Selfhelp programmes; Set (Psychology); Social psychiatry; Software; Therapists; Treatments; Waiting Lists; England; Mood disorder; Human; Help seeking; Attitude; Decision making; Satisfaction; Anxiety disorder; Psychotherapy; Depression; Treatment; Selfcare; Qualitative analysis; Expectation
• ISSN: 0020-7640; 1741-2854
• DOI: 10.1177/0020764006066841

Background: Access to psychological therapy is often difficult. Problems with access may be overcome through ‘minimal interventions’ (such as books and computer programs), which encourage self-help for mental health problems and are less dependent on the availability of specialist therapists. However, to be effective, such interventions must be acceptable to patients. Aims: To use qualitative methods to explore patient attitudes, by examining patient expectancies of psychological therapy and their experiences with a ‘minimal intervention’ (guided self-help). Methods: Qualitative interviews (N = 24) were conducted with patients after they had received guided self-help for depression as part of a randomised controlled trial. Results: There were important gaps between patients' expectancies of psychological therapy and their experience of the guided self-help. These gaps related to the process of therapy (e.g. time, professional expertise) and outcomes. Particularly salient was a theme relating to explanatory models. Patients were often seeking insight into the ‘cause’ of their current difficulties, whereas the minimal intervention was largely focused on symptom resolution. Conclusions: The effective implementation of ‘minimal interventions’ requires an understanding of the expectancies of patients concerning psychological therapy, in order to provide a basis for effective communication and negotiation between professionals and patients.