Hostname: page-component-cd9895bd7-dzt6s Total loading time: 0 Render date: 2024-12-25T08:13:21.917Z Has data issue: false hasContentIssue false
  • English
  • Français

IAPT and Long Term Medical Conditions: What Can We Offer?

Published online by Cambridge University Press:  11 March 2014

Abigail L. Wroe ,
Edward W. Rennie ,
Sarah Gibbons ,
Arek Hassy  and
Judith E. Chapman
Abigail L. Wroe*
Affiliation:
Berkshire Healthcare NHS Foundation Trust, and Royal Holloway University of London, UK
Edward W. Rennie
Affiliation:
Berkshire Healthcare NHS Foundation Trust, UK
Sarah Gibbons
Affiliation:
Berkshire Healthcare NHS Foundation Trust, UK
Arek Hassy
Affiliation:
Berkshire Healthcare NHS Foundation Trust, and Theale Medical Surgery, UK
Judith E. Chapman
Affiliation:
Berkshire Healthcare NHS Foundation Trust, UK
*
Reprint requests to Abigail L. Wroe, Department of Clinical Psychology, Royal Holloway University of London, Holloway Hill, Egham TW20 0EX, UK. E-mail: [email protected]
Get access Rights & Permissions [Opens in a new window]

Abstract

Background: The proposal of a 4-year plan to integrate treatment of people with long term medical conditions (LTCs) into the IAPT service (Department of Health, 2011) seeks for research to understand the effectiveness of IAPT interventions for this patient group. Aim: The aim of this service development pilot work was to develop an intervention that is effective for people with Type 2 Diabetes Mellitus (T2DM). It was hypothesized that the standard IAPT intervention would not be effective, but that it can be adapted so that it is effective both in terms of mood and self-management of T2DM. Method: Clients (n = 95) who experienced mild to moderate depression and/or anxiety and had a diagnosis of T2DM opted to attend. The intervention was adapted over a series of cohorts from a standard Step 2 intervention. A team of Psychological Wellbeing Practitioners (PWPs), a Clinical Health Psychologist and a General Practitioner worked in collaboration, using outcomes measures and feedback from service users and facilitators. Results: The standard IAPT Step 2 intervention met with challenges when specifically targeting this client group. Using paired t-tests, the modified Step 2 intervention demonstrated significant improvements from pre- to postintervention measures both in terms of psychological (n = 17) and physical (n = 9) outcomes. Conclusion: It is concluded that it may be possible to modify a generic Step 2 IAPT intervention to demonstrate improvements both in terms of psychological wellbeing and self-management of T2DM. The main adaptations were related to more targeted recruitment and linking of diabetes specifically into the CBT model.

Keywords

IAPTdepressionanxietylong term medical conditiondiabetesT2DMStep 2wellbeing course
Type
Research Article
Information
Behavioural and Cognitive Psychotherapy , Volume 43 , Issue 4 , July 2015 , pp. 412 - 425
Copyright
Copyright © British Association for Behavioural and Cognitive Psychotherapies 2014 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Alam, R., Sturt, J. and Winkley, K. (2009). An updated meta-analysis to assess the effectiveness of psychological interventions delivered by psychological specialists and generalist clinicians on glycaemic control, and on psychological status. Patient Education and Counselling, 75, 25–36.CrossRefGoogle ScholarPubMed
Anderson, R. J., Freedland, K. E., Clouse, R. E. and Lustman, P. J. (2001). The prevalence of comorbid depression in adults with diabetes: a meta-analysis. Diabetes Care, 24, 1069–1078.CrossRefGoogle ScholarPubMed
Ali, S., Stone, M. A., Peters, J. L., Davies, M. J. and Khunti, K. (2006). The prevalence of co-morbid depression in adults with Type 2 diabetes: a systematic review and meta-analysis. Diabetes Medicine, 23, 1165–1173.CrossRefGoogle ScholarPubMed
Clark, D. M., Layard, R., Smithies, R., Richards, D. A., Suckling, R. and Wright, B. (2009). Improving Access to Psychological Therapies: initial evaluation of two UK demonstration sites. Behaviour Research and Therapy, 47, 910–920.CrossRefGoogle ScholarPubMed
Collins, M. M., Cocoran, P. and Perry, I. J. (2009). Anxiety and depression symptoms in patients with diabetes. Diabetic Medicine, 26, 153–161.CrossRefGoogle ScholarPubMed
Currie, C. G., Peters, J. R., Tynan, A., Evans, M., Heine, R. J., Bracco, O. L., et al. (2010). Survival as a function of HbA1c in people with type 2 diabetes: a retrospective cohort study. The Lancet, 375, 481–189.CrossRefGoogle ScholarPubMed
Department of Health (2011). Talking Therapies: a four-year plan of action. London: DoH.Google Scholar
Diabetes, UK (2010). Emotional and Psychological Support and Care in Diabetes. London: Report from the emotional and psychological support working group of NHS Diabetes and Diabetes UKGoogle Scholar
Egede, L. E. and Ellis, C. (2010). Diabetes and depression: global perspectives. Diabetes Research and Clinical Practice, 87, 302–310.CrossRefGoogle ScholarPubMed
Gatchel, R. J., Peng, Y. B., Peters, M. L., Fuchs, P. N. and Turk, D. C. (2007). The biopsychosocial approach to chronic pain: scientific advances and future directions. Psychological Bulletin, 133, 581–624.CrossRefGoogle ScholarPubMed
Hopko, D. R. and Colman, L. K. (2010). The impact of cognitive interventions in treating depressed breast cancer patients. Journal of Cognitive Psychotherapy, 24, 314–328.CrossRefGoogle Scholar
Ismail, K., Winkley, K. and Rabe-Hesketh, S. (2004). Systematic review and meta-analysis of randomised controlled trials of psychological interventions to improve glycaemic control in patients with type 2 diabetes. The Lancet, 363 (9421), 1589–1597.CrossRefGoogle ScholarPubMed
Kroenke, K., Spitzer, R. L. and Williams, J. B. (2001). The PHQ-9: validity of a brief depression severity measure. Journal of General Internal Medicine, 16, 606–613.CrossRefGoogle ScholarPubMed
Lamers, F., Jonkers, C. C. M., Bosna, H., Knottnerus, J. A. and van Eijk, J. T. M. (2011). Treating depression in diabetes patients: does a nurse-administered minimal intervention affect diabetes-specific quality of life and glycaemic control? A randomized controlled trial. Journal of Advanced Nursing, 67, 788–799.CrossRefGoogle ScholarPubMed
Lin, E., Katon, W., Von Korff, M., Rutter, C., Simon, G. E., Oliver, M., et al. (2004). Relationship of depression and diabetes self-care, medication adherence, and preventive care. Diabetes Care, 27, 2154–2160.CrossRefGoogle ScholarPubMed
Lin, E. H. B., Rutter, C. M., Katon, W., Heckbert, S. R., Ciechanowski, P., Oliver, M. M., et al. (2010). Depression and advanced complications of diabetes: a prospective cohort study. Diabetes Care, 33, 264–269.CrossRefGoogle ScholarPubMed
Lustman, P. J. and Clouse, R. E. (2002). Treatment of depression in diabetes: impact on mood and medical outcomes. Journal of Psychosomatic Research, 53, 917–924.CrossRefGoogle Scholar
Markowitz, S. M., Gonzalez, J. S., Wilkinson, J. L. and Safren, S. A. (2011). A review of treating depression in diabetes: emerging findings. Psychosomatics, 52, 1–18.CrossRefGoogle ScholarPubMed
Meadows, K., Steen, N., McColl, M., Eccles, M., Shiels, C., Hewison, J., et al. (2006). The Diabetes Health Profile (DHP): a new instrument for assessing the psychosocial profile of insulin requiring patients - development and psychometric evaluation. Quality of Life Research, 5, 242–254.CrossRefGoogle Scholar
Morley, S., Eccleston, C. and Williams, A. (1999). Systematic review and meta-analysis of randomized controlled trials of cognitive behaviour therapy and behaviour therapy for chronic pain in adults, excluding headache. Pain, 80, 1–13.CrossRefGoogle ScholarPubMed
National Institute for Health and Clinical Excellence (NICE) (2009a). Depression in Adults (CG90). London: National Institute for Health and Clinical Excellence.Google Scholar
National Institute for Health and Clinical Excellence (NICE) (2009b). Depression in Adults with Chronic Physical Health Problems Clinical Guideline (CG91). London: National Institute for Health and Clinical Excellence.Google Scholar
National Institute for Health and Clinical Excellence (NICE) (2011a). Common Mental Health Disorders: identification and pathway to care (CG123). London: National Institute for Health and Clinical Excellence.Google Scholar
National Institute for Health and Clinical Excellence (NICE) (2011b). Generalised Anxiety Disorder and Panic (With or Without Agoraphobia) in Adults (CG113). London: National Institute for Health and Clinical Excellence.Google Scholar
Primary Care Diabetes Society (2011). Keeping People with Diabetes out of Hospital. www.pcdsociety.org/Keeping-People-with-Diabetes-out-of-Hosptial.pdfGoogle Scholar
Snoek, F. J., van der Ven, N. C. W., Twisk, J. W. R., Hogenelst, M. H. E., Tromp, A. M. E., van der Ploeg, H. M., et al. (2008). Cognitive Behavioural Therapy (CBT) compared with blood glucose awareness training (BGAT) in poorly controlled Type 1 diabetic patients: long-term effects on HbA1c moderated by depression: a randomized controlled trial. Diabetic Medicine, 25, 1337–1342.CrossRefGoogle ScholarPubMed
Snoek, F. J., Welch, G. W., Pouwer, F. and Polonsky, W. H. (2000). Diabetes-related emotional distress in Dutch and U.S. diabetic patients. Diabetes Care, 23, 1305–1309.CrossRefGoogle ScholarPubMed
Spitzer, R. L., Kroenke, K., Williams, J. B. and Löwe, B. (2006). A brief measure for assessing generalized anxiety disorder: the GAD-7. Archive for Internal Medicine, 166, 1092–1097.CrossRefGoogle ScholarPubMed
Toobert, D. J., Hampson, S. E. and Glasgow, R. E. (2000). The summary of diabetes self-care activities measure. Diabetes Care, 23, 943–950.CrossRefGoogle ScholarPubMed
Van der Feltz-Cornelis, C., Nuyen, J., Stoop, C., Chan, J., Jacobsen, A. M., Katon, W., et al. (2010). Effects of interventions for major depressive disorder and significant depressive symptoms in patients with diabetes mellitus: a systematic review and meta-analysis. General Hospital Psychiatry, 32, 380–395.CrossRefGoogle ScholarPubMed
Van der Ven, N. C. W., Hogenelst, M. H. E., Tromp-Wever, A. M. E., Twisk, J. W. R., van der Ploeg, H. M., Heine, R. J., et al. (2005). Short-term effects of cognitive behavioural group training (CBGT) in adult Type 1 diabetes patients in prolonged poor glycaemic control: a randomized controlled trial. Diabetic Medicine, 22, 1619–1623.CrossRefGoogle ScholarPubMed
Van Straten, A., Garaedts, A., Leeuw, I., Andersson, G. and Cuijpers, G. (2010). Psychological treatment of depressive symptoms in patients with medical disorders: a meta-analysis. Journal of Psychosomatic Research, 69, 23–32.CrossRefGoogle ScholarPubMed
Submit a response

Comments

No Comments have been published for this article.