As you like it: adopting a patient‐led approach to psychological treatments
| Published date | 15 March 2011 |
| Pages | 6-16 |
| DOI | https://doi.org/10.1108/17465721111134510 |
| Date | 15 March 2011 |
| Author | Timothy A. Carey |
| Subject Matter | Health & social care |
Research
As you like it: adopting a patient-led
approach to psychological treatments
Timothy A. Carey
Abstract
Purpose – The purpose of this paper is to look at the design and delivery of psychological treatments
offered by the UK National Health Service (NHS) and in particular, ask how much treatment is enough,
or who should decide when the patient has had enough treatment.
Design/methodology/approach – The data reported in this section were collected during routine
clinical practice in the NHS in Scotland.
Findings – It was found that treatments could be redesigned so that important therapeutic information
is provided in time frames that match patient preferences, leading to more efficient and effective
services.
Originality/value – Clinicians, predominantly, determine the design and delivery of treatment
programmes, whereas the paper suggests that programmes should be focused on the patient and their
needs.
Keywords United Kingdom, Mental health services, Psychology, Patient care, National Health Service
Paper type Research paper
The growing presence of psychological disorders in society is costly. At an individual
level, costs are experienced in terms of losses to personal fulfilment and independence.
Societally, costs are incurred through reduced productivity, work place absenteeism, and
increased consumption of health services, among other things. Increasing numbers of
people present to primary care settings with mental health problems (Simon and VonKorff,
1997). This growing population places a strain on existing services and challenges service
providers to ensure that treatments are being provided efficiently.
An efficient treatment should result in the resolution of psychological problems in a timely
manner. Treatment efficiency, therefore, involves person-effectiveness as well as
cost-effectiveness. Person-effectiveness ensures the amelioration of symptoms so that
people do not suffer needlessly. Cost-effectiveness refers to the expeditious resolution of
symptoms, which is important to ensure the responsible use of resources and the
sustainability of the service. The number of treatment sessions provided, therefore, is central
to treatment efficiency.
The importance of treatment parameters, such as how much treatment to provide,should not
be underestimated. Pressures to optimise time and financial resources are experienced
internationally (Barkham et al., 1999). Waiting lists in the United Kingdom (UK; White, 2000),
managed care’s reimbursement restrictions (Mueller and Pekarik, 2000), as well as
limitations by health maintenance organisations (Austad et al., 1988) in the USA are some of
the factors exerting pressure for effective and efficient services. It is imperative, therefore,
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JOURNAL OF PUBLIC MENTAL HEALTH
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VOL. 10 NO. 1 2011, pp. 6-16, QEmerald Group Publishing Limited, ISSN 1746-5729 DOI 10.1108/17465721111134510
Timothy A. Carey is an
Associate Professor in
Mental Health at the Centre
for Remote Health, the
Central Australian Mental
Health Service, and the
Centre of Research
Excellence in Rural and
Remote Primary Health
Care, Alice Springs,
Australia.
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