Increasing access to psychologically-informed care: A Cognitive Behavioural Therapy informed programme for multidisciplinary staff working in older peoples’ community mental health teams

Abstract

BackgroundIncreasing psychological skills and therapies in the wider workforce is essential for psychologists working with finite resources and a growing older adult population. While much of the focus within older peoples’ multidisciplinary teams (MDT) and training initiatives in Scotland are on memory and dementia, there is a need to consider the changing demand which may come from older people who are increasingly socialised to seeking support with mood difficulties.AimsA Cognitive Behaviour Therapy (CBT) informed programme was co-developed with multidisciplinary colleagues with the aim of developing a sustainable and ongoing infrastructure that would increase the competence and confidence of attendees in delivering psychologically informed care for older people experiencing common mood difficulties (anxiety and depression).MethodA one-day teaching session with six-weekly coaching groups was delivered. Outcome measures related to engagement and ‘benefit’; measured via a vignette assessing competence in CBT-based knowledge and skills and via subjective confidence ratings on CBT-based competencies. Acceptability and feasibility was tested via a pilot in 2018; and has subsequently ran in its present form since 2019.ResultsFrom 2019 to 2022, programme attendees have almost doubled and average coaching group attendance has increased from 30 per cent to 58 per cent. Competence and confidence scores have similarly increased. Qualitative feedback reflects patient-centred benefits including an increase in goal-focused interventions, collaborative working and formulation-based (rather than diagnosis-led) discussions during MDT meetings.Conclusions & ReflectionsThe programme outcomes indicate MDT acceptability and effectiveness. A model of teaching and follow-up coaching allows for ongoing knowledge and skill development and is believed to be an effective model for facilitating application of knowledge and skills to practice. Within the local health board, the programme has contributed to an infrastructure for psychologically informed care, increased knowledge of therapies for older people and provided a governance framework which is workable for an older adult psychology service to sustain. A key reflection has been the importance of modelling the CBT approach throughout the programme.