Research Watch: therapists’ working conditions and their implications for service users’ social inclusion
DOI | https://doi.org/10.1108/MHSI-11-2018-0038 |
Published date | 12 February 2019 |
Pages | 5-11 |
Date | 12 February 2019 |
Author | Sue Holttum |
Subject Matter | Health & social care,Mental health,Social inclusion |
Research Watch: therapists’working
conditions and their implications for
service users’social inclusion
Sue Holttum
Abstract
Purpose –The purpose of this paper is to highlight possible implications of therapists’working conditions on
social inclusion of service users.
Design/methodology/approach –A search was carried out for recent papers on cognitive behaviour
therapy (CBT) therapists.
Findings –One study highlighted that over half of their sample of 201 UK therapists in Improving Access to
Psychological Therapy (IAPT) services reported burnout. In a second study, in interviews with ten IAPT
workers in inner London services, therapists said they had to fight for extra time to adapt CBT for people who
had learning disabilities, and the additional stress made them feel less positive about working with these
clients. A third study, on therapists working with people with multiple sclerosis, highlights the importance of
adapting CBT for people with physical conditions.
Originality/value –Taken together, these three papers highlight concerning implications of current
working conditions for many therapists working in IAPT services. They highlight that sources of stress
include services’rigid focus on targets and inability to make expected adjustments. With regard to the UK,
this may be due to the current n ational service model, but it has imp lications for the social inclusi on of some
service users.
Keywords Learning disabilities, Multiple sclerosis, IAPT workers, Burnout, Social inclusion
Paper type Viewpoint
The ImprovingAccess to Psychological Therapies(IAPT) programme in theUK began in 2008 with
the remit of making it easier for people to get therapy for anxiety and depression (Layard, 2006).
However, as Westwood et al.(2017) pointed out, the IAPT programme’s remitis ever-increasing.
In this paper, I discuss three papers reporting on the experience of workers who deliver cognitive
behaviour therapy(CBT) for anxiety and depression. Westwood et al. (2017) reportedconcerning
levels of therapist burnout in English IAPT services. Marwood et al. (2017) reported therapists’
experience of trying to adapt CBT for people with learning disabilities in inner London IAPT
services. In Sweden, where CBT is also recommended for depression, Ytterberg et al. (2017)
reported on therapists’experiences of difficulty adapting CBT for people with a physical health
condition, multiple sclerosis (MS). All three paperssuggest that the current UK service model and
the pressure it can place on therapists may work against social inclusion for some service users.
Therapist burnout
Westwood et al. (2017) carried out a survey of therapists working in English IAPT services,
reaching those in 15 different services. As they explained, burnout in healthcare staff is thought to
be the result of long-lasting stress. Workers feel emotionally exhausted and it becomes harder to
care about service users (Demerouti et al., 2001; Maslach et al., 1996). Westwood et al. (2017)
used a questionnaire, the Oldenburg Burnout Inventory (Demerouti et al.,2001),toassess
IAPT workers’level of burnout. Their sample comprised 201 workers, of whom 105 were
psychological wellbeing practitioners, who deliver short-term CBT to a high number of clients
Sue Holttum is based at the
Salomons Centre for Applied
Psychology, Canterbury
Christ Church University,
Royal Tunbridge Wells, UK.
DOI 10.1108/MHSI-11-2018-0038 VOL. 23 NO. 1 2019, pp. 5-11, © Emerald Publishing Limited, ISSN 2042-8308
j
MENTALHEALTH AND SOCIAL INCLUSION
j
PAG E 5
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