Underwood, AW; (2014) Developing a Low Intensity CBT Intervention for GAD in IAPT: A Pilot Feasibility and Acceptability Study. Doctoral thesis (D.Clin.Psy), UCL (University College London).

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Abstract

Volume 1 of this thesis evaluates the development of a low intensity Cognitive Behavioural Therapy (CBT) intervention for Generalised Anxiety Disorder (GAD), its feasibility and acceptability. This volume consists of three parts. Part 1, the literature review, examines using meta-analysis and network meta-analysis the effectiveness of psychological treatments for pathological worry in Generalised Anxiety Disorder (GAD) using the Penn State Worry Questionnaire (PSWQ) as a primary outcome measure. The review also considers the relative effectiveness of currently available psychological treatments. The quality of the current evidence base and methodological issues are discussed and further research suggested. Part 2, the empirical paper, is a pilot study, which examines the feasibility and acceptability of the delivery of a brief guided self-help intervention for excessive worry and GAD, which drew on Behavioural Change Theory (Michie, Van Stralen & West, 2011) following a review of current interventions for GAD. The results showed that there was a clinical need for a specific worry and GAD intervention, that Understanding Worry (UW) was as acceptable to patients as Treatment as Usual (TAU) as there was no significant difference in drop out, attendance, cancellations or DNAs. There was no significant difference in post-treatment scores between UW and TAU in observed clinical contact and at session four as predicted by the Mixed Methods Linear Model (MMLM). Implications for treatment and further research are discussed. Part 3, the critical review, explores critically the empirical study, the background to the research, conceptual issues in the intervention design and the challenges of conducting research in NHS clinical settings. The review particularly focuses on recruitment and the involvement of clinicians the research process and future directions for research.

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