Enhancing the quality of psychological interventions delivered by telephone
Depression and anxiety are common mental health problems that can cause substantial difficulties for people who experience them. The NHS has created an innovative psychological therapy service called Improving Access to Psychological Therapy (IAPT), to help people with these conditions.
IAPT services support hundreds of thousands of people across the country who are experiencing anxiety and depression. Many of the psychological therapy sessions offered are delivered by telephone – a method recommended by the National Institute for Health and Care Excellence (NICE), who provide guidance for the delivery of healthcare.
Many people like the idea of treatment delivered by telephone because appointments are easier to access and can be less stigmatising compared to face-to-face appointments. However, in the NHS, many people fail to begin and complete telephone treatment, meaning that they do not receive the help that they need.
Professionals who support patients in IAPT have reported that they do not receive enough training to deliver treatment over the telephone, and both patients and professionals do not always feel they receive enough support for telephone therapy.
Through the EQUITy programme, we want to improve the way psychological therapies are delivered by telephone so that we can ensure that people receive the care that they need. We will work with patients and professionals to ensure our work is acceptable to the people accessing IAPT services and those supporting patients.
EQUITy is a £2.4 million research programme funded by the National Institute of Health Research’s Programme Grants for Applied Research funding stream.
Work on EQUITy began in April 2018 and will continue for five years.
The programme is divided into five workstreams:
Workstream 1: Understanding
The first stage of EQUITy was to understand the issues around telephone-delivered treatments in IAPT.
We worked with patients and professionals to understand their experiences of telephone treatments and the types of challenges they face, and we explored IAPT data to understand which groups of people experience the greatest difficulties with telephone-delivered treatments. Read our findings from our interviews with patients, practitioners and service leads.
Workstream 2: Intervention development
Once we understood the problem, we developed an intervention to help services improve the quality of telephone treatments.
Our previous work suggested that this intervention would need to include several different parts, including professional training, educational materials to help patients understand what telephone-delivered treatments are like and best-practice guidelines and workshops for IAPT teams.
Workstream 3: Patient Portal
Alongside our other workstreams, we have developed an online resource in collaboration with patients and professionals which has been designed to help people be better informed and more prepared for telephone treatment. We are in the process of interviewing patients to see what they think about these and find out whether they have found them helpful before commencing treatment.
Workstream 4: Evaluating
We are currently testing whether the introduction of our intervention might mean that more patients finish telephone treatment, and whether this has important benefits for their health and wellbeing.
We will check the number of treatment sessions that people attend and how they feel, comparing services that receive our intervention with ones that do not.
We will combine our data with data already available to see if our intervention has long-term benefits, and we will talk to patients and professionals about their experiences of telephone treatments following our intervention.
Workstream 5: Sharing findings
Over the course of the programme we have been communicating our findings through our blog, vlogs, journal articles and our Twitter page. Have a look through our website to see some of our work!
At the end of our programme we plan to offer our resources and consultation free-of-charge to NHS services and charities.
Our progress so far
How to get involved
There are always opportunities for practitioners and people who have received treatment from IAPT to be involved in our studies.
If you would like to take part or would like further information about the programme you can email us at firstname.lastname@example.org.
- Professor John Ainsworth (The University of Manchester)
- Professor Chris Armitage (The University of Manchester)
- Professor Michael Barkham (University of Sheffield)
- Dr Helen Brooks (University of Manchester)
- Professor Linda Davies (The University of Manchester)
- Professor Paul Drew (University of York)
- Professor Richard Emsley (Kings College London)
- Professor Simon Gilbody (University of York)
- Professor Peter Jones (University of Cambridge)
- Dr David Kessler (University of Bristol)
- Prof Karina Lovell (The University of Manchester)
- Dr Dean McMillan (University of York)
- Paul Wilson (The University of Manchester)
- Nicky Lidbetter (Anxiety UK)
Programme steering committee
EQUITy Lived Experience Advisory Panel (EQUITy LEAP)
The EQUITy Lived Experience and Advisory Panel (LEAP) provide independent advice and guidance to the EQUITy research team which his drawn from the lived experience of common mental health problems and IAPT services. They meet four times a year and undertake activities such as:
* Contributing to the development of research materials
* Advising on the development of participant recruitment methods
* Commenting on emerging data analysis
* Advise and participate in disseminating the findings from EQUITy to key stakeholders
* Contribute to the development of patient mediated materials.
You can find out more on their role by reading the EQUITy PPI blog, and hear from David about his experience of the EQUITy LEAP by watching the short video below:
This project is funded by the National Institute for Health Research (NIHR) Programme Grants for Applied Research NIHR programme (RP-PG-1016-20010). The views expressed are those of the author(s) and not necessarily those of the NIHR or the Department of Health and Social Care.