The role of intrinsic factors in the implementation of psychosocial interventions into routine clinical practice
| Published date | 01 June 2008 |
| DOI | https://doi.org/10.1108/17556228200800013 |
| Date | 01 June 2008 |
| Pages | 32-41 |
| Author | M Fleming,A Savage‐Grainge,C Martin,C Hill,S Brown,J Buckle,J Miles |
| Subject Matter | Health & social care |
32
The role of intrinsic factors in the
implementation of psychosocial
interventions into routine clinical practice
Abstract
Despite the efficacy, political will and numbers of
mental health practitioners trained in psychosocial
interventions, they remain scarcely available in
routine clinical practice. External factors such as the
inability of mental health organisations to develop
strategies to support the use of psychosocial
interventions have been implicated. This study
compares data from two groups, one that had
completed psychosocial intervention training
(n=104) and one that had not received psychosocial
intervention training (n=102). Both groups
completed measures of self-efficacy, locus of
control and an application of psychosocial
interventions to practice. Results showed that
psychosocial intervention training significantly
increased the level of self-efficacy for using
psychosocial interventions in practice. The group
that had received psychosocial interventions
training had lower internal locus of control
orientation. Self-efficacy was significantly related to
using psychosocial interventions in practice. There
is a discussion of the implications of these findings.
Key words
self-efficacy; locus of control; implementation;
psychosocial interventions
Defining psychosocial interventions
Non-pharmacological psychosocial interventions (PSIs)
have become core interventions in the first line treatment
of psychosis (NICE, 2002). The term came to prominence
in 1992 with the development of the Thorn training
initiative at the Institute of Psychiatry and the University
of Manchester. The key components of this training were
cognitive behavioural therapy (CBT) for the management
of psychotic symptoms, family interventions to help
carers cope and manage their relative’s behaviour more
effectively (FI) and case management to provide a
framework for delivering these interventions. These key
components have provided the framework for defining
PSI since 1992. The term remains difficult to define as the
evidence base progresses. The authors offer the following
definition: psychosocial interventions can be described as
a dynamic pool of non-pharmacological research that has
provided evidence to support the development of values-
based practice, frameworks for clinical practice and a
phenomenological understanding of the development
and maintenance of the experiences of psychosis. This has
then influenced mental health policy, clinical practice
guidelines and training.
Over the subsequent years from 1992 the amount of
PSI research continues to grow and provides evidence of
the efficacy of manualised PSI treatments through
randomised controlled trials (Pilling et al, 2002). Another
strand of empirical research has begun to identify the
psychosocial factors that influence the development and
maintenance of the most distressing psychotic experiences
such as voice hearing and delusions (Morrison, 1998;
Freeman & Garety, 2004). These experimental studies are
based on cognitive theory and their findings can be
translated directly into clinical practice through the use of
an individualised psychosocial explanation of the person’s
experience of psychosis. This process is called case
formulation and provides a framework for clinical practice
that puts the person experiencing psychosis at the centre
of the clinical work. Practitioners can now design
M Fleming, AP Savage-Grainge, CR Martin, C Hill, S Brown, J Buckle and JNV Miles
University of the West of Scotland/University of York
The Journal of Mental Health Training, Education and Practice Volume 3 Issue 2 June 2008 © Pavilion Journals (Brighton) Ltd
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