Barriers to disseminating brief CBT for voices from a lived experience and clinician perspective

PLoS One. 2017 Jun 2;12(6):e0178715. doi: 10.1371/journal.pone.0178715. eCollection 2017.

Abstract

Access to psychological therapies continues to be poor for people experiencing psychosis. To address this problem, researchers are developing brief interventions that address the specific symptoms associated with psychosis, i.e., hearing voices. As part of the development work for a brief Cognitive Behaviour Therapy (CBT) intervention for voices we collected qualitative data from people who hear voices (study 1) and clinicians (study 2) on the potential barriers and facilitators to implementation and engagement. Thematic analysis of the responses from both groups revealed a number of anticipated barriers to implementation and engagement. Both groups believed the presenting problem (voices and psychosis symptoms) may impede engagement. Furthermore clinicians identified a lack of resources to be a barrier to implementation. The only facilitator to engagement was reported by people who hear voices who believed a compassionate, experienced and trustworthy therapist would promote engagement. The results are discussed in relation to how these barriers could be addressed in the context of a brief intervention using CBT techniques.

MeSH terms

  • Adult
  • Attitude of Health Personnel
  • Cognitive Behavioral Therapy / methods*
  • Communication Barriers*
  • Female
  • Focus Groups
  • Hallucinations / psychology
  • Hallucinations / therapy*
  • Health Resources / supply & distribution
  • Humans
  • Male
  • Middle Aged
  • Patients / psychology
  • Physician-Patient Relations*
  • Psychiatry
  • Psychotic Disorders / psychology
  • Psychotic Disorders / therapy*
  • Schizophrenic Psychology
  • Self-Help Groups
  • Surveys and Questionnaires

Grants and funding

Support was provided by Sussex Partnership NHS Foundation Trust and the Economic and Social Research Council (ESRC) (Grant reference: ES/J500173/1).