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A brief adherence therapy: training issues and patients' satisfaction

Published online by Cambridge University Press:  13 June 2014

Marie Boilson
Affiliation:
Carseview Centre, 4 Tom McDonald Avenue, Dundee, Scotland
Jane M Murdoch
Affiliation:
Department of Mental Health, University of Aberdeen, Scotland
Alastair M Hull
Affiliation:
Murray Royal Hospital, Perth, PH2 7BH, Scotland
Ross J Hamilton
Affiliation:
Department of Mental Health, University of Aberdeen, Scotland
Jan Scott
Affiliation:
PO Box 96, Division of Psychological Medicine, Institute of Psychiatry, De Crespigny Park, London SE5 8AF, England

Abstract:

Objectives: Medication non-adherence in affective disorder is an area of concern. Abbreviated cognitive therapy for adherence (ACTA) is an intervention specifically designed to address this. Our objectives were to explore psychiatric trainees' experiences of delivering this therapy, and to examine patient satisfaction using the Client Satisfaction Questionnaire (CSQ).

Method: This preliminary study took place in two centres in Scotland. The experiences of five higher psychiatric trainees who underwent training in this novel approach were gathered at a ‘brain storming’ meeting after completing training, which included clinical application of the intervention. Also included is the preliminary feedback from a small number of participants involved in a randomised controlled pilot study of ACTA provided by these same trainees. In this pilot, 15 participants with bipolar affective disorder were allocated to receive ACTA (n = 7) or treatment as usual (TAU) (n = 8) and both groups completed a CSQ (client satisfaction questionnaire) at the end of the study.

Results: It was possible to learn and use this approach with limited previous experience of cognitive behavioural techniques. Longer structured sessions with the patients fostered the development of a collaborative relationship and facilitated negotiation of a treatment plan. There was 100% attendance rate for those receiving ACTA. Satisfaction scores for both the ACTA group and TAU group were high with median scores greater than 55 from a maximum of 60 in both groups. The ACTA group made additional positive comments.

Conclusions: Training in a brief therapy, such as ACTA, appears possible during psychiatric training and may represent a useful set of cognitive and behavioural techniques for busy clinicians. Preliminary findings suggest that patients like it.

Type
Brief reports
Copyright
Copyright © Cambridge University Press 2004

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References

1.Johnson, R, McFarland, B. Lithium use and discontinuation in a health maintenance organisation. Am J Psychiat 1996; 153: 9931000Google Scholar
2.Guscott, R, Taylor, L. Lithium prophylaxis in recurrent affective illness: efficacy, effectiveness and efficiency. Br J Psychiat 1994; 164: 741746CrossRefGoogle ScholarPubMed
3.Vestergaard, P. How effective is long-term lithium prophylaxis? Acta Psychiatr Scand 2000; 101: 341342Google ScholarPubMed
4.A pilot study of concordance therapy for individuals with bipolar disorder who are non-adherent with lithium prophylaxis. Bipolar Disorders 2002; 4: 386392.CrossRefGoogle Scholar
5.First, MB, Gibbon, M, Spitzer, RLet al.User's guide for the structured interview for DSM-IV Axis I Disorders – Research Version (SCID-I, version 2.0, February 1996 final version). New York: Biometrics ResearchGoogle Scholar
6.Larsen, DL, Attkisson, CC, Hargreave, WA, Nguyen, TD. Assessment of client/patient satisfaction: Development of a general scale. Evaluation and Programme Planning 1979;2:197207CrossRefGoogle ScholarPubMed
7.Scott, J, Palmer, S, Paykel, Eet al.Use of cognitive therapy for relapse prevention in chronic depression: Cost-effectiveness study. Br J Psychiat 2003; 182: 221227CrossRefGoogle ScholarPubMed
8.Bateman, A, Holmes, J. Psychotherapy training for psychiatrists: hope, resistance and reality. Psychiatric Bull 2001; 25: 124125CrossRefGoogle Scholar
9.Greenberger, D, Padesky, C. Mind Over Mood: A cognitive therapy treatment manual for clients. New York: The Guilford Press, 1995Google Scholar