What psychological and behaviour changes are initiated by 'expert patient' training and what training techniques are most helpful?

The Expert Patient Programme (EPP) is a lay-led, group-based, self-management training course available through the UK National Health Service for persons with long-term health conditions. Thirty-two patients who attended EPP courses in East London were interviewed about their experiences. Grounded theory coding of transcripts was employed to identify recurring accounts. Thematic analysis was used to theorise and organise participants' accounts, identifying commonly reported changes, helpful techniques and disappointments and frustrations. Results highlighted the role of information provision, especially face-to-face information exchange as well as the impact of in-class instruction and modelling of physical skills. Personal goal setting, using graded tasks, self-monitoring and goal review were regarded as the most useful techniques. Adoption and use of these self-management techniques depended on the establishment of an empathic and self-validating interpersonal context. Findings also imply that EPP may not be ideal for all participants and suggested modifications and improvements are discussed.