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Implementing cognitive therapies into routine psychosis care: organisational foundations.

Dark F, Whiteford H, Ashkanasy NM, Harvey C, Crompton D, Newman E - BMC Health Serv Res (2015)

Bottom Line: One of the services studied has since undertaken organisational structural reform to facilitate the greater uptake of Evidence Based Practice (EBP).Only 12% of staff were receiving therapy specific supervision.The Organisational Culture Profile (OCP) at baseline revealed highest scores amongst leadership, planning, and humanistic workplace domains, with communication receiving the lowest rating indicative of organisational weakness.

View Article: PubMed Central - PubMed

Affiliation: School Public Health, The University of Queensland, Brisbane, 4072, Australia. Frances.dark@health.qld.gov.au.

ABSTRACT

Background: Treatment outcomes for people diagnosed with psychosis remain suboptimal due in part to the limited systematic application of evidence based practice (Adm Policy Ment Health, 36: 1-7, 2009) [1]. The Implementation science literature identifies a number of factors organisationally that need to be considered when planning to introduce a particular EBP. Profiling these organisational characteristics at baseline, prior to commencement of service reform can determine the focus of a subsequent implementation plan. This study examined the organisational baseline factors existing in two services promoting the routine use of cognitive interventions for psychosis. One of the services studied has since undertaken organisational structural reform to facilitate the greater uptake of Evidence Based Practice (EBP). The results of this study were used to design an implementation strategy to make cognitive therapies a part of routine psychosis care.

Methods: One hundred-and-six mental health staff from two metropolitan mental health services in Australia was surveyed to ascertain their attitudes, competencies and interest in Cognitive Behavioural Therapy for psychosis (CBTp) and Cognitive Remediation Therapy (CRT). In addition perceptions of organisational values were profiled using the Organisational Culture Profile (OCP). Fifty five participants were excluded because they completed less than 50% of the survey. The final sample consisted of 51 participants.

Results: 48.1% of surveys were completed. Over 50% of staff were interested in CBTp and CRT approaches to psychosis. Staff were aware of existing CBTp and CRT programs but these were not uniformly available throughout the services. Fourteen percent of staff identified as CBT therapist and 35% were trained CRT facilitators. Only 12% of staff were receiving therapy specific supervision. The Organisational Culture Profile (OCP) at baseline revealed highest scores amongst leadership, planning, and humanistic workplace domains, with communication receiving the lowest rating indicative of organisational weakness.

Conclusion: Profiling the factors associated with successful implementation of service reform informed the implementation planning and the efficient deployment of resources in a mental health service introducing cognitive therapies for psychosis into routine clinical care. The majority of staff had positive attitudes to the evidence based cognitive therapies allowing a focus on training and supervision and the development of supporting organisational elements.

No MeSH data available.


Related in: MedlinePlus

Staff CBT/CRT survey
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Related In: Results  -  Collection

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Fig1: Staff CBT/CRT survey

Mentions: There were 51 complete responses from 106 surveys, constituting an 48.1 % completion rate. The survey found 59 % of staff were interested in CBT and 41 % interested in CRT. CBT principles were reported as being used routinely by 67 % of staff. Another 14 % of the sample identified themselves as CBT therapists having received formal undergraduate or postgraduate training. Therapy specific supervision was accessed by 12 % of staff. Twenty-four percent of staff have had specific training in CBTp. Thirty-five percent of staff were already trained and working as CRT facilitators with a further 41 % of staff interested in training in CRT to become program facilitators. The majority of staff indicated they were interested to learn more about cognition and cognitive assessment in psychosis (67 %) (Fig 1).


Implementing cognitive therapies into routine psychosis care: organisational foundations.

Dark F, Whiteford H, Ashkanasy NM, Harvey C, Crompton D, Newman E - BMC Health Serv Res (2015)

Staff CBT/CRT survey
© Copyright Policy - OpenAccess
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4526204&req=5

Fig1: Staff CBT/CRT survey
Mentions: There were 51 complete responses from 106 surveys, constituting an 48.1 % completion rate. The survey found 59 % of staff were interested in CBT and 41 % interested in CRT. CBT principles were reported as being used routinely by 67 % of staff. Another 14 % of the sample identified themselves as CBT therapists having received formal undergraduate or postgraduate training. Therapy specific supervision was accessed by 12 % of staff. Twenty-four percent of staff have had specific training in CBTp. Thirty-five percent of staff were already trained and working as CRT facilitators with a further 41 % of staff interested in training in CRT to become program facilitators. The majority of staff indicated they were interested to learn more about cognition and cognitive assessment in psychosis (67 %) (Fig 1).

Bottom Line: One of the services studied has since undertaken organisational structural reform to facilitate the greater uptake of Evidence Based Practice (EBP).Only 12% of staff were receiving therapy specific supervision.The Organisational Culture Profile (OCP) at baseline revealed highest scores amongst leadership, planning, and humanistic workplace domains, with communication receiving the lowest rating indicative of organisational weakness.

View Article: PubMed Central - PubMed

Affiliation: School Public Health, The University of Queensland, Brisbane, 4072, Australia. Frances.dark@health.qld.gov.au.

ABSTRACT

Background: Treatment outcomes for people diagnosed with psychosis remain suboptimal due in part to the limited systematic application of evidence based practice (Adm Policy Ment Health, 36: 1-7, 2009) [1]. The Implementation science literature identifies a number of factors organisationally that need to be considered when planning to introduce a particular EBP. Profiling these organisational characteristics at baseline, prior to commencement of service reform can determine the focus of a subsequent implementation plan. This study examined the organisational baseline factors existing in two services promoting the routine use of cognitive interventions for psychosis. One of the services studied has since undertaken organisational structural reform to facilitate the greater uptake of Evidence Based Practice (EBP). The results of this study were used to design an implementation strategy to make cognitive therapies a part of routine psychosis care.

Methods: One hundred-and-six mental health staff from two metropolitan mental health services in Australia was surveyed to ascertain their attitudes, competencies and interest in Cognitive Behavioural Therapy for psychosis (CBTp) and Cognitive Remediation Therapy (CRT). In addition perceptions of organisational values were profiled using the Organisational Culture Profile (OCP). Fifty five participants were excluded because they completed less than 50% of the survey. The final sample consisted of 51 participants.

Results: 48.1% of surveys were completed. Over 50% of staff were interested in CBTp and CRT approaches to psychosis. Staff were aware of existing CBTp and CRT programs but these were not uniformly available throughout the services. Fourteen percent of staff identified as CBT therapist and 35% were trained CRT facilitators. Only 12% of staff were receiving therapy specific supervision. The Organisational Culture Profile (OCP) at baseline revealed highest scores amongst leadership, planning, and humanistic workplace domains, with communication receiving the lowest rating indicative of organisational weakness.

Conclusion: Profiling the factors associated with successful implementation of service reform informed the implementation planning and the efficient deployment of resources in a mental health service introducing cognitive therapies for psychosis into routine clinical care. The majority of staff had positive attitudes to the evidence based cognitive therapies allowing a focus on training and supervision and the development of supporting organisational elements.

No MeSH data available.


Related in: MedlinePlus