OBJECTIVES: Despite national guidelines recommending cognitive-behavioural therapy (CBT) and family intervention (FI) in the treatment of schizophrenia, levels of implementation in routine care remain low. The present study investigates attitudinal factors amongst community mental health team (CMHT) staff affecting guideline implementation. DESIGN: CMHTs were audited to measure the capacity and delivery of CBT and FI, and semi-structured interviews were conducted with staff from the teams. Methods. Four CMHTs were audited, and five care coordinators from each team were interviewed. A purposive approach to sampling was used to represent the range of professional training of care coordinating staff. Data were analysed using thematic content analysis. RESULTS: Positive views towards guidelines were evident, although tempered by specific implementation issues. Employing simple psychological interventions and approaches as part of the care coordinating role also emerged as highly valued by staff. Severe workload, time pressure and the need for specialist staff were crucial barriers to implementation. Pessimistic views of recovery for clients with psychosis were also apparent and may affect implementation. CONCLUSIONS: Staff attitudes and knowledge are an important area of research when examining guideline implementation and require further study. Key themes that have emerged could inform future training agendas and should be considered when developing guideline implementation strategies for the updated 2009 guidelines.
OBJECTIVES: Despite national guidelines recommending cognitive-behavioural therapy (CBT) and family intervention (FI) in the treatment of schizophrenia, levels of implementation in routine care remain low. The present study investigates attitudinal factors amongst community mental health team (CMHT) staff affecting guideline implementation. DESIGN: CMHTs were audited to measure the capacity and delivery of CBT and FI, and semi-structured interviews were conducted with staff from the teams. Methods. Four CMHTs were audited, and five care coordinators from each team were interviewed. A purposive approach to sampling was used to represent the range of professional training of care coordinating staff. Data were analysed using thematic content analysis. RESULTS: Positive views towards guidelines were evident, although tempered by specific implementation issues. Employing simple psychological interventions and approaches as part of the care coordinating role also emerged as highly valued by staff. Severe workload, time pressure and the need for specialist staff were crucial barriers to implementation. Pessimistic views of recovery for clients with psychosis were also apparent and may affect implementation. CONCLUSIONS: Staff attitudes and knowledge are an important area of research when examining guideline implementation and require further study. Key themes that have emerged could inform future training agendas and should be considered when developing guideline implementation strategies for the updated 2009 guidelines.
Authors: Lorenza Magliano; John Read; Angela Rinaldi; Regina Costanzo; Renata De Leo; Giustina Schioppa; Miriam Petrillo Journal: Community Ment Health J Date: 2015-06-17
Authors: Andrew I Gumley; Simon Bradstreet; John Ainsworth; Stephanie Allan; Mario Alvarez-Jimenez; Maximillian Birchwood; Andrew Briggs; Sandra Bucci; Sue Cotton; Lidia Engel; Paul French; Reeva Lederman; Shôn Lewis; Matthew Machin; Graeme MacLennan; Hamish McLeod; Nicola McMeekin; Cathy Mihalopoulos; Emma Morton; John Norrie; Frank Reilly; Matthias Schwannauer; Swaran P Singh; Suresh Sundram; Andrew Thompson; Chris Williams; Alison Yung; Lorna Aucott; John Farhall; John Gleeson Journal: Health Technol Assess Date: 2022-05 Impact factor: 4.106
Authors: Karin Lowson; Michelle Jenks; Alexandra Filby; Louise Carr; Bruce Campbell; John Powell Journal: Implement Sci Date: 2015-06-30 Impact factor: 7.327