title: Long-term conditions and medically-unexplained symptoms: feasibility of cognitive behavioural interventions within the improving access to Psychological Therapies Programme.
abstract: BACKGROUND
  Improving access to psychological therapies (IAPT) is a major programme in England to treat common mental health problems, mainly through cognitive behaviour therapy. In 2012, a Pathfinder scheme was launched to develop interventions for people with chronic physical health conditions or medically-unexplained symptoms.
  
  
  OBJECTIVE
  This qualitative component of the evaluation investigated feasibility and acceptability of IAPT provision for people with enduring physical health problems.
  
  
  METHODS
  Qualitative interviews were conducted with project leaders in all 14 Pathfinder sites.
  
  
  RESULTS
  Various therapeutic and training interventions were introduced. Most patients received low-intensity, structured therapy, with high-intensity input provided by some Pathfinders for complex cases. Whether the focus was on psychological symptoms or on broader well-being, psychiatric terminology was avoided to improve utilisation. Participants perceived high satisfaction among service-users. Training needs were indicated for IAPT workers in this specialised work.
  
  
  CONCLUSIONS
  Cognitive behaviour interventions appeared to be acceptable for people struggling with physical health problems. Robust outcome evidence will be pursued in Phase II.
authors.affiliation: a Florence Nightingale School of Nursing & Midwifery, King's College London , London , UK and.
authors.forename: Niall
authors.initials: N
authors.lastname: McCrae
authors.affiliation: b Department of Health Care Management & Policy , University of Surrey , Guildford , Surrey , UK.
authors.forename: Ana
authors.initials: A
authors.lastname: Correa
authors.affiliation: b Department of Health Care Management & Policy , University of Surrey , Guildford , Surrey , UK.
authors.forename: Tom
authors.initials: T
authors.lastname: Chan
authors.affiliation: b Department of Health Care Management & Policy , University of Surrey , Guildford , Surrey , UK.
authors.forename: Simon
authors.initials: S
authors.lastname: Jones
authors.affiliation: b Department of Health Care Management & Policy , University of Surrey , Guildford , Surrey , UK.
authors.forename: Simon
authors.initials: S
authors.lastname: de Lusignan
mesh_terms: D001007:Anxiety / Q000517:prevention & control; D002908:Chronic Disease / Q000517:prevention & control*; D015928:Cognitive Behavioral Therapy / Q000193:education; D003863:Depression / Q000517:prevention & control; D005240:Feasibility Studies; D006297:Health Services Accessibility; D006801:Humans; D008605:Mental Health Services / Q000592:standards* / Q000706:statistics & numerical data; D017060:Patient Satisfaction; D036301:Qualitative Research; D016896:Treatment Outcome
keywords: Behaviour therapy; medically-unexplained symptoms; physical health conditions