Predictors of IAPT psychological well-being practitioners’ intention to use CBT self-help materials routinely in their clinical practice

Abstract

BACKGROUND: Despite efficacy and effectiveness evidence, and recommendations from the National Institute for Health and Care Excellence (NICE), use of CBT self-help materials remains inconsistent in UK mental health services. Since 2006, the Improving Access to Psychological Therapies (IAPT) programe provides standardised training and mandates routine use of CBT self-help materials by their trainee psychological well-being practitioners (PWPs).AIMS: This study tested whether the main constructs of the theory of planned behaviour (TPB; attitudes, subjective norms, and perceived behavioural control), past use, prior training and demographic characteristics, would predict PWPs' intention to use self-help materials routinely in their clinical practice.METHODS: Stage 1 utilised a standardised procedure to create measures for the constructs of the TPB, before the design and testing of a web-based, cross-sectional questionnaire. In Stage 2, the questionnaire was administered to a convenience sample of trainee PWPs (n=94). Data was analysed using multiple linear regression, mediation analyses, and content analysis.RESULTS: TPB constructs predicted intention to use self-help materials, with only direct attitude contributing significantly to 70% of the variance in intention. Past use of materials predicted intention, via direct and indirect mediation. Qualitative data from 43 trainees highlighted clients' experience of self-help materials as positive, albeit with some practical constraints. CONCLUSIONS:The results suggest that the main constructs of the TPB have some utility in predicting trainee PWPs' intention to use self-help materials routinely. Future prospective, longitudinal research could investigate actual use of self-help materials to elucidate cognitive factors involved in trainees' clinical decision-making post-qualification.

Does self-help increase rates of help seeking for student mental health problems by minimizing stigma as a barrier?

“…Consistent with the Theory of Planned Behavior, 21 greater self-help intentions were predicted by greater positive attitudes, self-efficacy, and normative beliefs about self-help as well as knowledge of self-help resources. This is consistent with previous research in other populations for ehealth more broadly, 22,23 but is the first study to examine these factors with college student mental health specifically. Future research seeking to increase the adoption of self-help resources among college students might evaluate interventions to improve knowledge of effective self-help resources, attitudes towards self-help 27 or normative beliefs about treatment.…”

“…Previous research suggests that variables indicated in the Theory of Planned Behavior 21 are predictive of intentions to use online self-help including normative beliefs, attitudes, and self-efficacy. 22,23 Thus, we Does self-help minimize stigma? 6 predicted that lower self-efficacy, attitudes, knowledge, and normative beliefs regarding selfhelp would all relate to lower intentions to use self-help.…”

“Attitudes to voices”: a survey exploring the factors influencing clinicians’ intention to assess distressing voices and attitudes towards working with young people who hear voices

“…The Theory of Planned Behavior (TPB; Ajzen, 2005 ) is a useful model for explaining clinician behaviors ( Eke et al, 2012 ; Levy et al, 2016 ; Lecomte et al, 2018 ). TPB proposes three main drivers of intention to perform an action: attitudes -comprising the imagined outcome of the action and how much that outcome is valued; subjective norms -comprising perceptions of what others would usually do and what they would approve or disapprove of doing, and how important that is to the person planning an action; and perceived behavioral control -comprising internal (e.g., self-efficacy for the action) and external facilitators and barriers (e.g., other duties that may need to be performed at a given time).…”