The DOI matches its Crossref record; 16 of the 17 references it cites were found in a registry or an index.
MULTIPLE ACCESS POINTS AND LEVELS OF ENTRY (MAPLE): ENSURING CHOICE, ACCESSIBILITY AND EQUITY FOR CBT SERVICES
Abstract
Mental health problems contribute 23% to the global burden of disease in developed countries (WHO, 1999). In the U.K., recent legislation attempts to address this by modernizing mental health services so that they provide evidence based, accessible and non-discriminatory services for both serious and common mental health problems. Cognitive behaviour therapy (CBT) has a robust evidence base that fits very well with the thrust of policy. However, CBT's delivery systems are rooted in traditional service models, which pay little attention to the growing evidence base for brief and single-strand treatments over complex or multi-strand interventions. Services characterized by 9-5 working, hourly appointments and face-to-face therapy disenfranchise the majority of people who would benefit from CBT. In this paper we argue that the evidence exists for service protocols that promote equity, accessibility and choice and that CBT services should be organized around multiple levels of entry and service delivery rather than the more usual secondary care referral systems.
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“Therefore, treatment costs tend to be higher compared to primary care (Spijker et al., 2013) in combination with long waiting lists due to treatment duration and limited financial resources (Bower and Gilbody, 2005, Lovell and Richards, 2000).”
From Development and initial evaluation of blended cognitive behavioural treatment for major depression in routine specialized mental health care (2016) · cites this paper as Lovell and Richards, 2000
In the citing paper
“However, many patients do not access these treatments for a number of reasons, such as concerns over side effects (Weisberg, Dyck, Culpepper, & Keller, 2007), patient or therapist unwillingness to engage in exposure therapy, lack of trained therapists (Gunter & Whittal, 2010), and scheduling difficulties (Lovell & Richards, 2000).”
From Socially anxious primary care patients' attitudes toward cognitive bias modification (CBM): A qualitative study (2012) · cites this paper as Lovell & Richards, 2000
In the citing paper
“Organising services with multiple levels of entry and service delivery, rather than the more traditional single referral gateway at the level of primary care into secondary care services, may help to increase access to psychological therapies.3”
From Can a self-referral system help improve access to psychological treatments? (2010) · cites this paper as [3]
In the citing paper
“However, because of their low capacity, access to psychological treatment services for individuals with these difficulties has often been variable and limited, with long waiting lists for these services.3”
From Can a self-referral system help improve access to psychological treatments? (2010) · cites this paper as [3]
In the citing paper
“necessitating alternatives to one-to-one treatment delivery (Lovell & Richards, 2000) beyond the existing adjunctive use of self-help materials (Keeley et al , 2002).”
From Clinical efficacy of computerised cognitive-behavioural therapy for anxiety and depression in primary care: Randomised controlled trial (2004) · cites this paper as Lovell & Richards, 2000
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“Stepped care ideas originated in the USA, although theMAPLEmodel (Lovell & Richards, 2000) is an example proposed as suitable for the UK.”
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“Cognitive behaviour therapy (CBT) has emerged as the leading evidence-supported form of brief psychological therapy for people with depression.(4,5) However, demand for CBT cannot be met from existing therapist resources.”
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“Patients can thus access an appropriate level of treatment and, if needed, access a more intensive intervention without first having had to receive a lower-intensity treatment.(14)”
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“Targeting interventions through multiple access points can improve choice, accessibility and equity (Richards, 2000) but can fragment care without appropriate co-ordination.”
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“When they do, they are commonly put on long waiting lists (Lovell and Richards 2000), and the treatment that they eventually receive is often not evidence based (Andrews et al.”
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Patients with head and neck cancer prefer individualized cognitive behavioural therapy
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Ha, S. W., & Kim, J. (2020) · International Journal of Human-Computer Interaction · doi:10.1080/10447318.2020.1750792 · Cited by 32
“…counseling and the number of counselors who can provide counseling, creating considerable waiting times for those in need of counseling and thereby preventing clients from receiving the immediate treatment they need to deal with their problems (Lovell & Richards, 2000; Steinman et al., 2015).”
BackgroundSalloum, A. (2010) · Professional Psychology Research and Practice · doi:10.1037/a0018330 · Cited by 33
Dowrick, C., Chew-Graham, C., Lovell, K., Lamb, J., Aseem, S., Beatty, S., Bower, P., Burroughs, H., Clarke, P., Edwards, S., et al. (2013) · Programme Grants for Applied Research · doi:10.3310/pgfar01020 · Cited by 27
Self-citationImproving access to primary mental health care: uncontrolled evaluation of a pilot self-help clinic.
Lovell, K., Richards, D. A., & Bower, P. (2003) · Europe PMC (PubMed Central) · Cited by 27
Self-citationAn evaluation of a collaborative bibliotherapy scheme delivered via a library service
Macdonald, J. B., Vallance, D., & McGrath, M. (2012) · Journal of Psychiatric and Mental Health Nursing · doi:10.1111/j.1365-2850.2012.01962.x · Cited by 26
Liu, E. T.-H., Chen, W., Li, Y.-H., Wang, C. H., Mok, T. J., & Huang, H. S. (2008) · Cognitive Therapy and Research · doi:10.1007/s10608-008-9228-4 · Cited by 26
“The accumulating evidence suggests that bibliotherapy is an effective treatment modality (Cuijpers 1997; Gould and Clum 1993; Lovell and Richards 2000; Shechtman 2006; Williams 2003), for individuals ranging in age from adolescents (Ackerson et al. 1998) to older adults (Floyd et al. 2004; Gregory…”
BackgroundWaiting times for primary care psychological therapy and counselling services
Trusler, K., Doherty, C., Mullin, T., Grant, S., & McBride, J. (2006) · Counselling and Psychotherapy Research · doi:10.1080/14733140600581358 · Cited by 25
Zhao, D., Lustria, M. L. A., & Hendrickse, J. (2017) · Patient Education and Counseling · doi:10.1016/j.pec.2017.01.004 · Cited by 27
Lewis, H., Adamson, J., Atherton, K., Bailey, D., Birtwistle, J. C., Bosanquet, K., Clare, E., Delgadillo, J., Ekers, D., Foster, D., et al. (2017) · Health Technology Assessment · doi:10.3310/hta21080 · Cited by 23
“Additionally, the implementation of any form of care will require a strategy that both is of low intensity and can be offered within primary care.(18) In recent years an organisational model of care has been introduced called collaborative care.”
BackgroundSelf-citationThe use of automated assessments in internet-based CBT: The computer will be with you shortly
Mason, E. C., & Andrews, G. (2014) · Internet Interventions · doi:10.1016/j.invent.2014.10.003 · Cited by 24
“Although the effects of CBT outlast the treatment itself, it is widely recognized that there are simply not enough trained clinicians to cater for the number of patients who could benefit from it (Lovell and Richards, 2000; Williams and Martinez, 2008).”
BackgroundCollins, N., & Corna, L. (2018) · BJPsych Bulletin · doi:10.1192/bjb.2018.10 · Cited by 22
Nooteboom, L. A., van den Driesschen, S. I., Kuiper, C. H. Z., Vermeiren, R. R. J. M., & Mulder, E. A. (2020) · Child and Adolescent Psychiatry and Mental Health · doi:10.1186/s13034-020-00321-x · Cited by 23
Gellatly, J. L., Pedley, R., Molloy, C., Butler, J. A., Lovell, K., & Bee, P. (2017) · BMC Psychiatry · doi:10.1186/s12888-017-1238-x · Cited by 24
“Similar to the management of other mental health problems, such as anxiety and depression, access to recommended treatments within the UK mental health system has in the past failed to meet demand with many people faced with long waiting times [6, 7].”
BackgroundSelf-citationGilbody, S. M., Brabyn, S., Mitchell, A. S., Ekers, D., McMillan, D., Bailey, D., Hems, D., Chew-Graham, C. A., Keding, A., & Bosanquet, K. (2021) · American Journal of Geriatric Psychiatry · doi:10.1016/j.jagp.2021.06.006 · Cited by 19
Fraser, C., Beasley, M., Macfarlane, G. J., & Lovell, K. (2019) · BMC Musculoskeletal Disorders · doi:10.1186/s12891-019-2584-2 · Cited by 21
Self-citationTherapists’ attitudes to offering eCBT in an inner-city IAPT service: a survey study
Meisel, S. F., Drury, H., & Perera-Delcourt, R. P. (2018) · The Cognitive Behaviour Therapist · doi:10.1017/s1754470x18000107 · Cited by 21
“One-to-one therapy is labour intensive, costly, and inherently limited in terms of the number of patients that can be seen at any one time (Lovell and Richards, 2000; Stallard et al. , 2010).”
Bio‐phobias/techno‐philias: virtual reality exposure as treatment for phobias of ‘nature’
Davidson, J., & Smith, M. (2003) · Sociology of Health & Illness · doi:10.1111/1467-9566.00363 · Cited by 21
“The most likely course of treatment provided will be Cognitive Behavioural Therapy (CBT) involving between 6–12, weekly sessions of 45–60 minutes in the therapist’s office (Lovell and Richards 2000).”
BackgroundAge Discrimination in Mental Health Services
Beecham, J. K., Knapp, M. R. J., Fernández, J., Huxley, P. J., Mangalore, R., McCrone, P., Snell, T., Winter, B., & Wittenberg, R. (2008) · Kent Academic Repository (University of Kent) · Cited by 21
Turner, J., Kelly, B., Clarke, D., Yates, P., Aranda, S., Jolley, D., Forbes, A., Chambers, S., Hargraves, M., & Mackenzie, L. (2017) · Supportive Care in Cancer · doi:10.1007/s00520-016-3382-0 · Cited by 21
“However, emerging evidence suggests that brief interventions may be as effective as complex longer term interventions [28, 29].”
BackgroundTherapist and Treatment-Seeking Students’ Perceptions of Telemental Health
Petersen, D., Salazar, B. C., & Kertz, S. J. (2019) · Journal of Technology in Behavioral Science · doi:10.1007/s41347-019-00116-8 · Cited by 24
Psychosocial Issues and Care for Patients with Systemic Sclerosis
Jewett, L. R., Kwakkenbos, L., Delisle, V. C., Levis, B., & Thombs, B. D. (2016) · Springer eBooks · doi:10.1007/978-3-319-31407-5_45 · Cited by 20
Lucock, M., Kirby, R., & Wainwright, N. (2011) · British Journal of Clinical Psychology · doi:10.1348/014466510x520231 · Cited by 23
“unsuccessful should more intensive interventions be offered (Davison, 2000; Lovell and Richards, 2000).”
BackgroundPragmatic evaluation of the viability of CCBT self‐help for depression in higher education
Mitchell, N., & Dunn, K. (2007) · Counselling and Psychotherapy Research · doi:10.1080/14733140701565987 · Cited by 20
Psychological advocacy toward healing (PATH): study protocol for a randomized controlled trial
Brierley, G., Agnew-Davies, R., Bailey, J., Evans, M. A., Fackrell, M., Ferrari, G., Hollinghurst, S. P., Howard, L. M., Howarth, E., Malpass, A., et al. (2013) · Trials · doi:10.1186/1745-6215-14-221 · Cited by 19
“Access to psychological support within the National Health Service (NHS) in the United Kingdom is often difficult [13], and standard psychological interventions such as counseling and cognitive-behavior therapy (CBT) that are not adapted to the specific needs of this vulnerable group have often failed to meet their ne…”
BackgroundSimon, N. A., Ploszajski, M., Lewis, C., Smallman, K., Roberts, N. P., Kitchiner, N., Brookes‐Howell, L., & Bisson, J. I. (2021) · Psychology and Psychotherapy Theory Research and Practice · doi:10.1111/papt.12341 · Cited by 22
rmn, M. T. R. (2010) · Journal of Psychiatric and Mental Health Nursing · doi:10.1111/j.1365-2850.2009.01544.x · Cited by 19
Metadata
- Authors
- Lovell, K., & Richards, D.
- Affiliations
- University of Manchester (GB)
- Venue
- Behavioural and Cognitive Psychotherapy
- Publisher
- Cambridge University Press (CUP)
- Published
- 2000-10
- Volume
- 28
- Issue
- 4
- Pages
- 379-391
- ISSN
- 1352-4658 (ISSN-L)
- 1469-1833
- OpenAlex
- W2155900414
- Cited by
- 216
- References
- 17
- Citations by year
- 2026: 1 · 2025: 4 · 2024: 6 · 2023: 6 · 2022: 6 · 2021: 4 · 2020: 5 · 2019: 9 · 2018: 3 · 2017: 8 · 2016: 7 · 2015: 9 · 2014: 8 · 2013: 12 · 2012: 12
- FWCI
- 9.27
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Behavioural and Cognitive Psychotherapy (publishedVersion)
- Topics
- Social Sciences › Psychology › Applied Psychology › Digital Mental Health Interventions
- Health Sciences › Medicine › Psychiatry and Mental health › Mental Health Treatment and Access
- Social Sciences › Psychology › Clinical Psychology › Psychiatric care and mental health services
- Keywords
- cognitive behavioral therapy, mental health services, service organizations, accessibility, equity, choice, brief intervention, secondary care referral, service delivery models, mental health policy
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