Working with UWE Bristol graduates from both undergraduate and Masters programmes, Dr Miles Thompson, Senior Lecturer in Psychology and co-lead of the Psychological Sciences Research Group (PSRG), publishes a study exploring which aspects of an low-intensity Cognitive Behavioural Therapy (CBT) intervention delivered through Improving Access to Psychological Therapy (IAPT) contributed to successful outcomes from the service user point of view.
IAPT services are not without their critics, but the aim of this mixed methods study was to both identify the elements of interventions which contributed to successful outcomes from the service user point of view, and also to attempt to frame the results within the common versus specific factor framework. Common versus specific factors refers to a sometimes acrimonious debate within the psychological literature about what matters most: common factors which are present in all therapies, or specific factors which are only found in certain interventions.
Eight participants took part in this multi-stage research which used both qualitative interviews and a quantitative questionnaire. In stage 1, participants spoke freely about any factors that played a role in their successful treatment as they saw it. In stage 2, participants were given a list of possible contributors to therapeutic change, to encourage them to consider factors they may not have otherwise thought of. Finally, in stage 3, participants were invited to reflect on whether their answers to stage 1 had changed at all following the stage 2 questionnaire. Interestingly, participants did not significantly change their answers after stage 2, and felt their initial responses reflected the most helpful aspects of their therapy.
Five overarching qualitative themes were identified in the data. Three relating to common factors – i. insight, ii. talking and iii. therapist qualities and two relating to specific factors – i. responding differently to thoughts and feelings and ii. tasks/activities. Importantly, all participants spoke about the importance of both common and specific factors. This may suggest that both factors, not just one or other, play an important role in successful outcomes.
It also seems important to note, that “talking” was a key factor in successful outcomes from the service users’ point of view. Some research into IAPT notes that allowing service users the space and time to talk can sometimes be constrained. This study highlights the importance of allowing talking to happen in all its fullness.
Future research that gains a fuller understanding of service user perceptions into why their interventions were successful may provide more evidence about what aspects of treatment are important. This may both increase our understanding of therapeutic processes and help us improve real-world outcomes.
The full publication is freely accessible to all both online and to download here.