Cognitive behaviour therapy within assertive outreach teams: barriers to implementation: a qualitative peer audit.

Area of Science:

• Mental Health
• Psychiatry
• Clinical Psychology

Background:

• Assertive outreach is an evidence-based intervention with proven effectiveness, primarily in the USA.
• Implementation of assertive outreach teams in the UK is recent, with recommendations to offer cognitive behaviour therapy (CBT).
• Existing literature suggests barriers to the routine delivery of CBT for psychosis (CBTp).

Purpose of the Study:

• To assess if clinicians' experiences with CBTp implementation barriers align with reported literature.
• To identify specific barriers encountered by UK assertive outreach teams.

Main Methods:

• A qualitative peer audit was conducted at the National Forum for Assertive Outreach Annual Conference in 2006.
• Team representatives discussed barriers to implementing psychosocial interventions in their local areas.

Main Results:

• Clinicians identified organizational, managerial, supervision, and local-specific barriers to CBTp implementation.
• Specific barriers included lack of organizational investment, CBT's structured nature, caseloads, medication issues, sensory impairment applicability, staff apathy, and burnout.

Conclusions:

• Assertive outreach teams are encountering significant barriers to implementing evidence-based therapies like CBTp.
• Further research is needed on the outreach model and CBTp integration within these teams.