Abstract There is growing evidence regarding the effectiveness of mindfulness-based interventions offered to diagnostically diverse groups of participants. This study examined the feasibility and effectiveness of adapted Mindfulness-Based Cognitive Therapy (MBCT) groups offered to NHS patients in a secondary-care Psychology and Psychotherapy Service. The group was run as an adjunct to individual therapy and accepted referrals from all therapists in the service, so participants had experienced a range of therapeutic approaches prior to attending the group. The nine groups run during the project also included staff participants, as part of a capacity-building strategy. Results indicate high levels of acceptability, with low drop-out rates. Standardized outcome measures were used to examine the effectiveness of the group, and patient participants demonstrated improvements which were statistically significant. Qualitative feedback from group participants and referrers was positive. The findings support implementation of MBCT as part of a package of psychological therapy interventions. Further research regarding this form of MBCT is discussed.
Community-based intensive home treatment (IHT) is delivered as an alternative to psychiatric hospital admission as part of crisis resolution services. People receiving IHT present with complex mental health issues and are acutely distressed. Home treatment options are often preferred and there is evidence of service fidelity, although less is known about psychosocial care in this setting. Underpinned by a critical realist epistemology, this study aimed to explore psychosocial care in the context of home treatment from the perspectives of staff, service users and family carers. Data were collected using individual interviews and focus groups in two NHS organisations in England. An inductive qualitative thematic analysis resulted in five themes focused on (1) the staffing model and effective care provision, (2) the organisation of work and effective care provision, (3) skills and training and service user need, (4) opportunities for involvement and personal choice, and (5) effective communication. Findings suggest that co-production may improve congruence between IHT service design, what service users and carers want and staff ideals about optimal care. Service designs that optimise continuity of care and effective communication were advocated. Staff training in therapeutic interventions was limited by not being tailored to the home treatment context. Evidence gaps remain regarding the most effective psychosocial care and related training and supervision required. There is also a lack of clarity about how carers and family members ought to be supported given their often-crucial role in supporting the person between staff visits.
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