A feasibility study of a cross-diagnostic, CBT-based psychological intervention for acute mental health inpatients: Results, challenges, and methodological implications

Paterson, Charlotte; Karatzias, Thanos; Harper, Sean; Dougall, Nadine; Dickson, Adele; Hutton, Paul

Abstract

Objectives
Acute psychiatric inpatient wards are characterised by minimal provision of therapeutic activities and high readmission rates. Implementation of a comprehensive inpatient psychological intervention service has been recommended to overcome these problems, however whether this is feasible or effective remains unclear.
Methods
This non-randomised parallel cluster feasibility trial examined the feasibility of delivering and evaluating cross-diagnostic psychologically informed acute psychiatric care (the E-Acute Psychological Inpatient Therapy Service; EDAPTS), and gathered preliminary clinical outcome data. Patients able to consent and complete questionnaires were recruited from two adult acute wards (i.e. clusters) and received either EDAPTS plus TAU or TAU.
Results
Between October 2015 and 2016, 96 inpatients were recruited. Findings suggested there were good data completion rates for several clinical outcomes, that several EDAPTS components were successfully delivered and that some initial effects appeared to favour the intervention, depending on outcome. However difficulties relating to the recruitment process were also identified, as well as problems relating to adequate delivery of group therapies, participant engagement in some intervention components, and data-completion at follow-up.
Conclusion
These issues, and the feasibility of randomisation and rater-blinding, have important implications for the design of future trials. Overall, this study provides an important insight into the challenges and complexities of developing and evaluating a comprehensive psychological intervention service in an acute psychiatric setting.

Citation

Paterson, C., Karatzias, T., Harper, S., Dougall, N., Dickson, A., & Hutton, P. (2019). A feasibility study of a cross-diagnostic, CBT-based psychological intervention for acute mental health inpatients: Results, challenges, and methodological implications. British Journal of Clinical Psychology, 58(2), 211-230. https://doi.org/10.1111/bjc.12209

• Journal Article Type: Article
• Acceptance Date: Nov 1, 2018
• Online Publication Date: Dec 2, 2018
• Publication Date: 2019-06
• Deposit Date: Nov 1, 2018
• Publicly Available Date: Dec 2, 2018
• Journal: British Journal of Clinical Psychology
• Print ISSN: 0144-6657
• Electronic ISSN: 2044-8260
• Publisher: Wiley
• Peer Reviewed: Peer Reviewed
• Volume: 58
• Issue: 2
• Pages: 211-230
• DOI: https://doi.org/10.1111/bjc.12209
• Keywords: Clinical Psychology; General Medicine
• Public URL: http://researchrepository.napier.ac.uk/Output/1331624
• Contract Date: Nov 1, 2018