title: Low intensity interventions for Obsessive-Compulsive Disorder (OCD): a qualitative study of mental health practitioner experiences.
abstract: Obsessive-compulsive disorder (OCD) is a debilitating mental health disorder that can substantially impact upon quality of life and everyday functioning. Guidelines recommend pharmacological and psychological treatments, using a cognitive behaviour therapy approach (CBT) including exposure and response prevention, but access has generally been poor. Low intensity psychological interventions have been advocated. The evidence base for these interventions is emerging but there is a paucity of information regarding practitioners' perceptions and experiences of supporting individuals with OCD using this approach.
  
  
  
  Qualitative interviews were undertaken with psychological wellbeing practitioners (PWPs) (n = 20) delivering low intensity psychological interventions for adults with OCD within the context of a large pragmatic effectiveness trial. Interviews explored the feasibility and acceptability of delivering two interventions; guided self-help and supported computerised cognitive behaviour therapy (cCBT), within Improving Access to Psychological Therapies (IAPT) services in NHS Trusts. Interviews were recorded with consent, transcribed and analysed using thematic analysis.
  
  
  
  PWPs acknowledged the benefits of low intensity psychological interventions for individuals experiencing OCD symptoms on an individual and population level. Offering low intensity support provided was perceived to have the opportunity to overcome existing service barriers to access treatment, improve patient choice and flexibility. Professional and service relevant issues were also recognised including self-beliefs about supporting people with OCD and personal training needs. Challenges to implementation were recognised in relation to practitioner resistance and intervention delivery technical complications.
  
  
  
  This study has provided insight into the implementation of new low intensity approaches to the management of OCD within existing mental health services. Benefits from a practitioner, service and patient perspective are identified and potential challenges highlighted.
  
  
  
  Current Controlled Trials: ISRCTN73535163 . Date of registration: 5 April 2011.
authors.affiliation: Division of Nursing, School of Health Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester Academic Health Science Centre, Manchester, M13 9PL, UK. judith.l.gellatly@manchester.ac.uk.
authors.forename: Judith
authors.initials: J
authors.lastname: Gellatly
authors.affiliation: Division of Nursing, School of Health Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester Academic Health Science Centre, Manchester, M13 9PL, UK.
authors.forename: Rebecca
authors.initials: R
authors.lastname: Pedley
authors.affiliation: Division of Nursing, School of Health Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester Academic Health Science Centre, Manchester, M13 9PL, UK.
authors.forename: Christine
authors.initials: C
authors.lastname: Molloy
authors.affiliation: Division of Psychology and Mental Health, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Centre, Manchester, M13 9PL, UK.
authors.forename: Jennifer
authors.initials: J
authors.lastname: Butler
authors.affiliation: Division of Nursing, School of Health Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester Academic Health Science Centre, Manchester, M13 9PL, UK.
authors.forename: Karina
authors.initials: K
authors.lastname: Lovell
authors.affiliation: Division of Nursing, School of Health Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester Academic Health Science Centre, Manchester, M13 9PL, UK.
authors.forename: Penny
authors.initials: P
authors.lastname: Bee
mesh_terms: D000328:Adult; D001291:Attitude of Health Personnel; D015928:Cognitive Behavioral Therapy; D005260:Female; D006801:Humans; D008297:Male; D009771:Obsessive-Compulsive Disorder / Q000628:therapy*; D036301:Qualitative Research; D012648:Self Care / Q000523:psychology*; D013813:Therapy, Computer-Assisted; D055815:Young Adult
keywords: Acceptability; Computerised cognitive behaviour therapy; Guided self-help; Low intensity intervention obsessive-compulsive disorder; Qualitative