Published online by Cambridge University Press: 13 June 2014
Objectives: Medication non-adherence in affective disorder is an area of concern. Abbreviated cognitive therapy for adherence (ACTA) is an intervention specifically designed to address this. Our objectives were to explore psychiatric trainees' experiences of delivering this therapy, and to examine patient satisfaction using the Client Satisfaction Questionnaire (CSQ).
Method: This preliminary study took place in two centres in Scotland. The experiences of five higher psychiatric trainees who underwent training in this novel approach were gathered at a ‘brain storming’ meeting after completing training, which included clinical application of the intervention. Also included is the preliminary feedback from a small number of participants involved in a randomised controlled pilot study of ACTA provided by these same trainees. In this pilot, 15 participants with bipolar affective disorder were allocated to receive ACTA (n = 7) or treatment as usual (TAU) (n = 8) and both groups completed a CSQ (client satisfaction questionnaire) at the end of the study.
Results: It was possible to learn and use this approach with limited previous experience of cognitive behavioural techniques. Longer structured sessions with the patients fostered the development of a collaborative relationship and facilitated negotiation of a treatment plan. There was 100% attendance rate for those receiving ACTA. Satisfaction scores for both the ACTA group and TAU group were high with median scores greater than 55 from a maximum of 60 in both groups. The ACTA group made additional positive comments.
Conclusions: Training in a brief therapy, such as ACTA, appears possible during psychiatric training and may represent a useful set of cognitive and behavioural techniques for busy clinicians. Preliminary findings suggest that patients like it.