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Barriers and facilitators to providing CBT for people living with dementia: perceptions of IAPT clinicians

Baker, Samantha; (2019) Barriers and facilitators to providing CBT for people living with dementia: perceptions of IAPT clinicians. Doctoral thesis (D.Clin.Psy), UCL (University College London). Green open access

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Abstract

Background: People living with dementia and mild cognitive impairment (MCI) commonly experience anxiety and depression, and cognitive behavioural therapy (CBT) is a recommended treatment for adults, commonly provided through national Improving Access to Psychological Therapies (IAPT) services. This study explored the barriers and facilitators to providing CBT interventions in IAPT for people living with dementia or MCI, as perceived by IAPT clinicians. Method: An interview topic guide was developed based on implementation theory and a consultation process. 14 participants were recruited through IAPT services and interviewed about their experience of working with individuals with dementia or MCI, and their ideas about factors that enhance or hinder offering CBT in IAPT to this group. Interview recordings were transcribed and results analysed using thematic analysis. Credibility checks were incorporated throughout the process. Results: Three main themes were identified: attitudes towards dementia, competing demands of offering a service to people with dementia/MCI, and pressure without support. Barriers included high pressures on staff with a low level of support, negative attitudes towards dementia and older adults, and a restrictive service model perceived to be at odds with offering a service adapted to peoples’ needs. Perceived facilitators were positive engagement and outcomes for people with dementia and MCI, positive attitudes of IAPT clinicians and the ability of some services to be flexible. Conclusions: Multiple perceived barriers and facilitators were identified, and there are implications for commissioning practices within the NHS relating to the tension between minimal resources and adequate care, as well as supporting clinicians working within this context.

Type: Thesis (Doctoral)
Qualification: D.Clin.Psy
Title: Barriers and facilitators to providing CBT for people living with dementia: perceptions of IAPT clinicians
Event: UCL (University College London)
Open access status: An open access version is available from UCL Discovery
Language: English
Additional information: Copyright © The Author 2019. Original content in this thesis is licensed under the terms of the Creative Commons Attribution 4.0 International (CC BY 4.0) Licence (https://creativecommons.org/licenses/by/4.0/). Any third-party copyright material present remains the property of its respective owner(s) and is licensed under its existing terms. Access may initially be restricted at the author’s request.
UCL classification: UCL
UCL > Provost and Vice Provost Offices
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences
URI: https://discovery.ucl.ac.uk/id/eprint/10083641
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