In this study, a convergent parallel mixed-methods design was used to explore stress, resilience and coping in psychological wellbeing practitioner (PWP) trainees (n = 90) at the beginning of their training. Psychometric tests were used to measure levels of self-reported stress, resilience and dispositional coping styles. Open-text survey data regarding the perceived sources of stress at the beginning of training were also qualitatively analysed using thematic analysis (TA). Results indicated that in the early weeks of their training, trainees reported lower levels of resilience and higher levels of stress than those found in the general population. Statistically significant negative correlations were found between stress and resilience, and between stress and the coping styles ‘Planning’, and ‘Active Coping’. Statistically significant positive correlations were found between stress and the coping styles of ‘Denial’ and ‘Focus on and Venting of Emotions’. The qualitative findings provided a context within which to understand these quantitative results. The three themes ‘I can find the unknown quite unsettling’, ‘I question my competences’ and ‘Learning, consolidating and putting it all into practice’ were generated through the qualitative analysis. These themes were connected by an over-arching theme which suggests that the perceived responsibility of the role is an important source of stress for PWP trainees. Implications for future research and the training of PWPs are discussed.

Guided CBT self-help represents a low-intensity intervention to deliver evidence-based psychological therapy within the Improving Access to Psychological Therapies (IAPT) programme. Best practice guidance highlighting characteristics associated with CBT self-help is available to help services reach decisions regarding which interventions to adopt. However, at present a single process to evaluate written CBT self-help interventions informed by guidance is lacking. This study reports on the development of a standardised criteria-driven process that can be used to determine the extent written CBT self-help interventions are consistent with guidance regarding the fundamental characteristics of low-intensity CBT and high-quality written patient information. Following development, the process was piloted on 51 IAPT services, with 23 interventions identified as representing free-to-use written CBT self-help interventions. Overall, inter-rater reliability was acceptable. Following application of the criteria framework, 14 (61%) were considered suitable to be recommended for use within the IAPT programme. This pilot supports the development and potential utility of an independent criteria-driven process to appraise the suitability of written workbook-based CBT self-help interventions for use within the IAPT programme.

Background: Little is understood about the relationship between therapist competence and the outcomes of patients treated for common mental health disorders. Furthermore, the evidence is yet to extend to competence in the delivery of low-intensity cognitive behavioural interventions. Understanding this relationship is essential to the dissemination and implementation of low-intensity cognitive behavioural interventions. Aims: The aim of this study was to explore the relationship between Psychological Well-being Practitioner (PWP) competence and patient outcome within the framework of the British government's Improving Access to Psychological Therapies (IAPT) initiative. Method: Forty-seven PWPs treating 3688 patients participated. Relationships between PWP scores on three observed standardized clinical examinations and reliable change in patients’ symptoms of anxiety and depression were explored at two time points: during the year-long training phase, and over a 12-month follow-up. Results: Results indicated that patients treated by qualified PWPs achieved superior outcomes than those treated by trainees. Little support was found for a general association between practitioner competence in delivering low-intensity cognitive behavioural interventions and patient outcome, either during or post-training; however, significantly more patients of the most competent PWPs demonstrated reliable improvement in their symptoms of anxiety and depression than would be expected by chance alone and fewer deteriorated compared with those treated by the least competent PWPs. Conclusion: Results were indicative of a complex, non-linear relationship, with patient outcome affected by PWP status (trainee or qualified) and by competence at its extremes. The implications of these results for the dissemination and implementation of low-intensity cognitive behavioural interventions are discussed.

Background: “Stress Control” (SC) has been adopted as a core intervention in step 2 of Improving Access to Psychological Therapies (IAPT) services, but contemporary evidence of effectiveness has lagged behind service uptake. Aims: To investigate the acceptability and effectiveness of SC and to explore moderators of outcome. Method: Analysis of acceptability (via attendance rates) and effectiveness (via IAPT minimum dataset). Results: SC was well tolerated with 73.3% of all patients and 75.4% of “clinical cases” attending three or more sessions. Of the 546 “clinical cases” attending SC and not in receipt of other interventions, 37% moved to recovery. Attendance improved outcome; for those patients attending all SC sessions the recovery rate rose to 59.2%. Conclusion: SC appears a well-tolerated and effective intervention that enables large numbers to gain access to treatment in an organizationally efficient manner. Attendance is important in facilitating SC outcomes and research evaluating attendance interventions are needed.