Doctorate in Clinical Psychology: Main Research Portfolio

: (Alternative Format Thesis). 1) International rates of receipt of psychological therapy for psychosis and schizophrenia; 2) An audit to identify rates of uploaded 5 Ps Formulations in an adult community mental health service; 3) A study investigating the implementation of NICE recommended psychological interventions for people with psychosis following a psychiatric inpatient admission.

Abstract

Background: The period of time following discharge from an inpatient setting presents a unique window of opportunity for people to engage in psychological treatment. In England, The National Institute for Health and Care Excellence (NICE) guidelines outline that every person with a schizophrenia diagnosis should be offered individual Cognitive Behavioural Therapy for psychosis (CBTp) and Family Intervention (FI).

Objectives: This study aimed to explore rates of offer and receipt of NICE recommended therapies for adults under the Oxford Health NHS Foundation Trust with a schizophrenia spectrum disorder diagnosis in the year following discharge from an inpatient unit. We then investigated possible predictors of therapy offer and receipt including gender, ethnicity, marital status and team discharged into following admission.

Methods: This study used a large electronic healthcare records database to perform a secondary data analysis to identify rates of therapy offer and receipt. A generalised linear regression model was used to explore possible predictors.

Findings: We explored data for 460 service users for one year following discharge from an inpatient unit. Overall, our results showed low rates of offer and receipt of recommended therapies (CBT received = 32(7%), CBT offered = 51(11%), FI received = 12(3%), FI offered 31(7%), Any recommended therapy (CBT only, FI only or CBT + FI) received = 39(8%), Any recommended therapy offered = 70(15%)). We found that people were less likely to have been offered or to have received recommended therapies if they were discharged into a non-Early Intervention (non-EI) team than people in Early Intervention (EI) teams or with no onward referral ((OR=0.20 (0.12-0.36), pConclusions: Our study identified low rates of offer and receipt of recommended therapies and highlighted the need for more consistent and reliable procedures for recording this information. Lower rates of offer and receipt of recommended therapies for people in non-EI teams reflect developments in Early Intervention services.

Clinical implications: Further investigation into the reasons for low levels of implementation overall is important to aid the development of recommendations for how this can be improved.

Date of Award	26 Jun 2023
Original language	English
Awarding Institution	University of Bath
Supervisor	Pamela Jacobsen (Supervisor)