Personality disorder co-morbidity in primary care ‘Improving Access to Psychological Therapy’ (IAPT) services: a qualitative study exploring patient perspectives on treatment experience

Lamph, Gary; Baker, John; Dickinson, Tommy; Lovell, Karina

Abstract

Background:
High numbers of people present with common mental health disorders and co-morbid personality disorder traits in primary care ‘Improving Access to Psychological Therapies’ (IAPT) services in England and they receive sub-optimal treatments. No previous studies have explored the treatment experiences or needs of this patient population in England.

Aims:
This qualitative study explored the treatment experiences of patients (n = 22) with common mental health difficulties and co-morbid personality disorder as indicated by a score of 3 or more on the ‘Standardised Assessment of Personality – Abbreviated Scale’ (SAPAS) in receipt of primary care-based IAPT treatment.

Method:
A qualitative health research approach was used. Qualitative individual face-to-face semi-structured interviews were conducted. All interviews were audio recorded, data were transcribed verbatim and analysed using a framework analysis approach.

Results:
Findings revealed a need to adapt away from prescriptive cognitive behavioural therapy (CBT) treatment models towards more flexible, personalised and individualised treatment with this patient group. Time to emotionally offload, build a therapeutic relationship and link past experiences to presenting problems were highlighted as important.

Conclusions:
For the first time, the needs and treatment experiences of this patient group have been explored. This paper provides a unique patient experience insight that should be considered when exploring new approaches to working with and developing effective interventions via a stepped care approach.

Citation

Lamph, G., Baker, J., Dickinson, T., & Lovell, K. (2021). Personality disorder co-morbidity in primary care ‘Improving Access to Psychological Therapy’ (IAPT) services: a qualitative study exploring patient perspectives on treatment experience. Behavioural and Cognitive Psychotherapy, 49, 144–158. https://doi.org/10.1017/S1352465820000594

• Journal Article Type: Article
• Acceptance Date: Jun 30, 2020
• Online Publication Date: Sep 8, 2020
• Publication Date: 2021-03
• Deposit Date: Feb 26, 2024
• Journal: Behavioural and Cognitive Psychotherapy
• Print ISSN: 1352-4658
• Publisher: Cambridge University Press
• Peer Reviewed: Peer Reviewed
• Volume: 49
• Pages: 144–158
• DOI: https://doi.org/10.1017/S1352465820000594