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Barriers and facilitators to providing CBT for people living with dementia: perceptions of psychological therapists

Baker, S; Brede, J; Cooper, R; Charlesworth, G; Stott, J; (2021) Barriers and facilitators to providing CBT for people living with dementia: perceptions of psychological therapists. Clinical Psychology and Psychotherapy 10.1002/cpp.2674. (In press).

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Abstract

Many people living with dementia or mild cognitive impairment (MCI) experience anxiety and depression. Cognitive behavioral therapy (CBT) is a recommended treatment for adults, commonly provided through primary care psychological therapies services. This study explored the facilitators and barriers to providing CBT interventions for people living with dementia or MCI, as perceived by therapists working in such services. Structured interviews were conducted with fourteen clinicians recruited through primary care psychological therapies services about their experiences of working with people living with dementia or MCI and their ideas about factors that enhance or hinder offering and delivering CBT to this population. Interview recordings were transcribed and analyzed using Thematic Analysis. Credibility checks were incorporated throughout. Three themes were identified: 'attitudes towards dementia', 'competing demands', and 'pressure without support'. Perceived facilitators and barriers occurred across individual, service, and system levels. Facilitators were: positive engagement and outcomes for people living with dementia or MCI, positive attitudes of clinicians, and flexibility within some services. In contrast, perceived barriers were: stigma towards dementia and mental health in older adults, high pressure on staff to perform with a lack of support to do so, exclusion based on diagnosis, and inflexibility within some services. Clinicians were confident that people living with dementia or MCI could benefit from CBT, with some adaptations to delivery. There are implications for staff support and training, and for commissioning practices relating to the tension between minimal resources, equitable access, and person-centered care.

Type: Article
Title: Barriers and facilitators to providing CBT for people living with dementia: perceptions of psychological therapists
Location: England
DOI: 10.1002/cpp.2674
Publisher version: https://doi.org/10.1002/cpp.2674
Language: English
Additional information: This version is the author accepted manuscript. For information on re-use, please refer to the publisher’s terms and conditions.
Keywords: Anxiety, Cognitive Behavioral Therapy, Dementia, Depression, Mild Cognitive Impairment, Service experience
UCL classification: UCL
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
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > Div of Psychology and Lang Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > Div of Psychology and Lang Sciences > Clinical, Edu and Hlth Psychology
URI: https://discovery.ucl.ac.uk/id/eprint/10136228
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