Fiona Switzer, Sean Harper and David Peck
The purpose of this paper is to identify barriers for people with psychotic spectrum disorders accessing CBTp in NHS Lothian. Despite national guidelines recommending CBT for the…
Abstract
Purpose
The purpose of this paper is to identify barriers for people with psychotic spectrum disorders accessing CBTp in NHS Lothian. Despite national guidelines recommending CBT for the treatment of schizophrenia (National Institute for Health and Care Excellence Guidelines 2014) and (Scottish Intercollegiate Guidelines Network Guidelines 2013), levels of access to CBTp remain low. The overall goal of the study is to uncover emergent themes regarding barriers to access to CBT for patients with psychosis. In addition, the influence of psychosocial skills intervention (PSI) training for psychosis (Brooker and Brabban, 2006) will be explored and if completion of this training effects referral behaviours and attitudes to CBTp.
Design/methodology/approach
This study is a quantitative service evaluation project which uses a questionnaire design to explore the factors that influence a clinician’s decision to refer a patient for CBTp. Three qualitative questions are included for thematic analysis to allow the respondents to elaborate on their views on potential barriers. All appropriate Community Mental Health Team (CMHT) staff in adult mental health in NHS Lothian were invited to participate in the study.
Findings
CMHT staff in NHS Lothian hold favourable views of CBTp and would support an increase in access for patients with psychosis. Key barriers to access for CBTp identified in this study comprise of, little or no access to CBTp, lack of integration of services and unclear referral pathways. Further themes emerging from the study also included, improving multi-disciplinary communication and increasing CMHT staff knowledge and confidence in CBTp. PSI training was shown to have a significant effect on referral rates. Further research would be warranted to explore the influence of PSI training on CMHT staff confidence and knowledge in CBTp.
Originality/value
This is the first paper of its kind to investigate the potential barriers to access to CBTp in Scotland. The paper has highlighted some key barriers and potential strategies to overcome the barriers identified will be discussed.
Details
Keywords
Discussions on the appropriate international regime to govern trade in biofuels are in their infancy. However, a large number of countries have set minimum blending targets for…
Abstract
Discussions on the appropriate international regime to govern trade in biofuels are in their infancy. However, a large number of countries have set minimum blending targets for biofuels. Meeting these targets will require greater production and increased international trade in biofuels. Concerns exist as to whether unsustainable practices will be used to satisfy this growing demand. There is currently no multilateral agreement governing sustainable production and trade in biofuels. In the absence of an international framework, this paper will seek to demonstrate that concerned countries may unilaterally regulate imports of unsustainably produced biofuels in a way that is consistent with international trade rules. Unilateral regulation is to be understood as a stop gap until multilateral agreement can be reached on the interaction between trade in biofuels and issues of sustainability.