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International Journal of Social Psychiatry
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A Qualitative Study of Patients' Perceptions of a ‘Minimal’ Psychological Therapy

Wendy Macdonald

National Primary Care Research and Development Centre, University of Manchester, Williamson Building, Oxford Road, Manchester M13 9PL, UK; wendy.macdonald{at}man.ac.uk

Nicola Mead

Peter Bower

National Primary Care Research and Development Centre, University of Manchester, UK

David Richards

Department of Health Sciences, University of York, UK

Karina Lovell

Department of Nursing, Midwifery and Health Visiting, University of Manchester, UK

Background: Access to psychological therapy is often difficult. Problems with access may be overcome through ‘minimal interventions’ (such as books and computer programs), which encourage self-help for mental health problems and are less dependent on the availability of specialist therapists. However, to be effective, such interventions must be acceptable to patients.

Aims: To use qualitative methods to explore patient attitudes, by examining patient expectancies of psychological therapy and their experiences with a ‘minimal intervention’ (guided self-help).

Methods: Qualitative interviews (N = 24) were conducted with patients after they had received guided self-help for depression as part of a randomised controlled trial.

Results: There were important gaps between patients' expectancies of psychological therapy and their experience of the guided self-help. These gaps related to the process of therapy (e.g. time, professional expertise) and outcomes. Particularly salient was a theme relating to explanatory models. Patients were often seeking insight into the ‘cause’ of their current difficulties, whereas the minimal intervention was largely focused on symptom resolution.

Conclusions: The effective implementation of ‘minimal interventions’ requires an understanding of the expectancies of patients concerning psychological therapy, in order to provide a basis for effective communication and negotiation between professionals and patients.

International Journal of Social Psychiatry, Vol. 53, No. 1, 23-35 (2007)
DOI: 10.1177/0020764006066841
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[Abstract] [PDF]