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Personality disorder co-morbidity in primary care ‘Improving Access to Psychological Therapy’ (IAPT) services: a qualitative study exploring patient perspectives on treatment experience

Published online by Cambridge University Press:  08 September 2020

Gary Lamph Open the ORCID record for Gary Lamph [Opens in a new window] ,
John Baker ,
Tommy Dickinson  and
Karina Lovell
Gary Lamph*
Affiliation:
Faculty of Health and Wellbeing, University of Central Lancashire, Preston, UK
John Baker
Affiliation:
Faculty of Medicine and Health, University of Leeds, Leeds, UK
Tommy Dickinson
Affiliation:
Florence Nightingale Faculty of Nursing, Midwifery & Palliative Care, Kings College London, London, UK
Karina Lovell
Affiliation:
Faculty of Biology Medicine and Health, University of Manchester, Manchester, UK
*
*Corresponding author. Email: [email protected]
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Abstract

Background:

High numbers of people present with common mental health disorders and co-morbid personality disorder traits in primary care ‘Improving Access to Psychological Therapies’ (IAPT) services in England and they receive sub-optimal treatments. No previous studies have explored the treatment experiences or needs of this patient population in England.

Aims:

This qualitative study explored the treatment experiences of patients (n = 22) with common mental health difficulties and co-morbid personality disorder as indicated by a score of 3 or more on the ‘Standardised Assessment of Personality – Abbreviated Scale’ (SAPAS) in receipt of primary care-based IAPT treatment.

Method:

A qualitative health research approach was used. Qualitative individual face-to-face semi-structured interviews were conducted. All interviews were audio recorded, data were transcribed verbatim and analysed using a framework analysis approach.

Results:

Findings revealed a need to adapt away from prescriptive cognitive behavioural therapy (CBT) treatment models towards more flexible, personalised and individualised treatment with this patient group. Time to emotionally offload, build a therapeutic relationship and link past experiences to presenting problems were highlighted as important.

Conclusions:

For the first time, the needs and treatment experiences of this patient group have been explored. This paper provides a unique patient experience insight that should be considered when exploring new approaches to working with and developing effective interventions via a stepped care approach.

Keywords

Improving Access to Psychological Therapies (IAPT)personality disorderprimary care
Type
Main
Information
Behavioural and Cognitive Psychotherapy , Volume 49 , Issue 2 , March 2021 , pp. 144 - 158
Copyright
© British Association for Behavioural and Cognitive Psychotherapies 2020

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