Multiple obstacles to psychological care from the viewpoint of addiction service users

Abstract

Purpose – The purpose of this paper is to explore addiction service users’ experiences of psychological interventions for depression symptoms, with an emphasis on understanding obstacles to engage with treatment. Design/methodology/approach – This was a thematic analysis of semi-structured interviews with ten people who took part in a randomised controlled trial of cognitive and behavioural interventions; four of whom never engaged with treatment. Findings – Five prominent obstacles to access therapy were: memory deficits, becoming overwhelmed by multiple demands and appointments, being housebound due to fluctuations in mental health problems, tendency to avoid the unfamiliar, and contextual life problems related to deprivation and social conflict. Research limitations/implications – The authors note some possible limitations related to overreliance on telephone interviews and interviewers’ field notes. The authors discuss the findings in light of epidemiological research, cognitive, behavioural and motivational enhancement theories. Practical implications – The authors propose it is important to recognise and address multiple obstacles to therapy. Offering therapy appointments that are co-located within addiction services and time-contingent to other social/medical interventions may help to address some of these obstacles. Originality/value – The present qualitative results complement the prior experimental research and enrich the understanding of how to maximise engagement with psychological interventions.

An adaptive method for assigning clinical trials wait-times for controls

“…This assumption is often not met in clinical conditions. Participant factors including employment flexibility, socioeconomic status, transportation availability, and even underlying physical, mental, or emotional health may affect the ability a participant to receive planned therapy [ [23] , [24] , [25] , [26] , [27] ]. When the aWLC method is applied in clinical situations, we expect the Stage I durations for the control group will be both more variable and longer than the current simulation study implies.…”

Patients' experiences of cognitive behavioural therapy and eye movement desensitisation and reprocessing as treatments for obsessive‐compulsive disorder

“…The topic guide was based on a modified version of the interview schedule used in a previous study of patients’ experiences of psychological care (Gore et al., ). The semis‐tructured interview included nine questions (and standard prompts) designed to elicit patients’ views about the treatment procedures, rationale, effects, appraisal of benefits versus difficulties, specific impact on OCD symptoms, overall assessment of therapy, recommendations and any other comments.…”

“…Qualitative process-outcome research is particularly useful to explore patients' experiences of treatment as a complement to quantitative methods (McLeod, 2001). Qualitative interviews are well-suited to identify valuable idiographic information such as obstacles to treatment adherence (Gore, Mendoza & Delgadillo, 2015) or unusual adverse reactions to aspects of treatment that other patients experience as neutral or beneficial (Levy, Glass, Arnkoff & Gershefski, 1996). To our knowledge, however, no previous studies have qualitatively compared patients' experiences of OCD and EMDR for this condition.…”