Embedding telephone therapy in statutory mental health services: a qualitative, theory-driven analysis
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BACKGROUND: Telephone-administered cognitive behavioural therapy (T-CBT) has attracted international recognition as a potential means of providing effective psychological treatment whilst simultaneously lowering costs, maximizing service efficiency and improving patient access to care. A lack of rigorous exploration of therapist perspectives means that little is known about professional readiness to adopt such delivery models, or the work that may be involved in ensuring successful implementation. METHODS: This paper reports on a qualitative exploration of professional views of high intensity T-CBT. Semi-structured interviews with 18 UK accredited Cognitive Behavioural Therapists with nursing or allied health backgrounds were collected and analysed according to Normalisation Process Theory, a contemporary and empirically-derived theory of health technology implementation. RESULTS: Despite increasing research effort seeking to determine the effectiveness of T-CBT, the clinical rationale for its use remains insecure. Professional perceptions of T-CBT as a high risk delivery strategy emerge as a key factor delaying T-CBT routinisation in practice. T-CBT champions draw on experiential knowledge to demonstrate that remote services can add value, a key factor being the recognition that telephone-mediated services can provide viable access for hard to reach populations. T-CBT uptake will be facilitated by i) the modification of existing protocols to address new methods of exchanging information and data, and (ii) greater clarification of the reach and span of telephone therapies, including the most appropriate division of labour across different service levels and settings. CONCLUSIONS: The integration and normalisation of high intensity T-CBT into mental health services demands greater recognition and redress of the existing socio-technical matrices within which nursing and allied health practitioners work. The future spread of higher intensity T-CBT is contingent upon the willingness of service managers to support staff in the delivery and governance of non-face-to-face therapy models. Clear delineation of the role and scope of T-CBT and the extent to which it will extend or replace existing provision is required.
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The use of the telephone for delivery of psychological interventions has enabled wider access to treatment for patients.
“The use of the telephone for the delivery of psychological interventions has undoubtedly enabled wider access to treatment for patients [10–12].”
From 'I didn't know what to expect': Exploring patient perspectives to identify targets for change to improve telephone-delivered psychological interventions (2020) · cites this paper as [12]
The Background describes telephone-supported therapy as a proposed response to inequitable access, and the Results (Coherence) report professionals’ views that it could increase access for people unable to attend face-to-face sessions. These passages support the access rationale, but do not establish that telephone delivery has already widened patient access as definitively as the citing sentence states. (LLM, conf=0.85)
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Self-citationFaija, C., Gellatly, J. L., Barkham, M., Lovell, K., Rushton, K., Welsh, C., Brooks, H. L., Ardern, K., Bee, P., & Armitage, C. J. (2021) · Figshare · doi:10.6084/m9.figshare.14600614
Self-citationFaija, C., Gellatly, J. L., Barkham, M., Lovell, K., Rushton, K., Welsh, C., Brooks, H. L., Ardern, K., Bee, P., & Armitage, C. J. (2021) · Figshare · doi:10.6084/m9.figshare.14600569
Self-citationFaija, C., Gellatly, J. L., Barkham, M., Lovell, K., Rushton, K., Welsh, C., Brooks, H. L., Ardern, K., Bee, P., & Armitage, C. J. (2021) · Figshare · doi:10.6084/m9.figshare.14600566
Self-citationFaija, C., Gellatly, J. L., Barkham, M., Lovell, K., Rushton, K., Welsh, C., Brooks, H. L., Ardern, K., Bee, P., & Armitage, C. J. (2021) · Figshare · doi:10.6084/m9.figshare.14600596
Self-citationFaija, C., Gellatly, J. L., Barkham, M., Lovell, K., Rushton, K., Welsh, C., Brooks, H. L., Ardern, K., Bee, P., & Armitage, C. J. (2021) · Figshare · doi:10.6084/m9.figshare.14600608
Self-citationFaija, C., Gellatly, J. L., Barkham, M., Lovell, K., Rushton, K., Welsh, C., Brooks, H. L., Ardern, K., Bee, P., & Armitage, C. J. (2021) · Figshare · doi:10.6084/m9.figshare.14600593
Self-citationFaija, C., Gellatly, J. L., Barkham, M., Lovell, K., Rushton, K., Welsh, C., Brooks, H. L., Ardern, K., Bee, P., & Armitage, C. J. (2021) · Figshare · doi:10.6084/m9.figshare.14600605
Self-citationFaija, C., Gellatly, J. L., Barkham, M., Lovell, K., Rushton, K., Welsh, C., Brooks, H. L., Ardern, K., Bee, P., & Armitage, C. J. (2021) · Figshare · doi:10.6084/m9.figshare.14600590
Self-citationFaija, C., Gellatly, J. L., Barkham, M., Lovell, K., Rushton, K., Welsh, C., Brooks, H. L., Ardern, K., Bee, P., & Armitage, C. J. (2021) · Figshare · doi:10.6084/m9.figshare.14600578
Self-citationPettersen, S., Eide, H., & Berg, A. (2024) · Figshare · doi:10.6084/m9.figshare.26705169
Pettersen, S., Eide, H., & Berg, A. (2024) · Figshare · doi:10.6084/m9.figshare.26705172
Faija, C., Gellatly, J. L., Barkham, M., Lovell, K., Rushton, K., Welsh, C., Brooks, H. L., Ardern, K., Bee, P., & Armitage, C. J. (2021) · Figshare · doi:10.6084/m9.figshare.14600575
Self-citationFaija, C., Gellatly, J. L., Barkham, M., Lovell, K., Rushton, K., Welsh, C., Brooks, H. L., Ardern, K., Bee, P., & Armitage, C. J. (2021) · Figshare · doi:10.6084/m9.figshare.14600587
Self-citationFaija, C., Gellatly, J. L., Barkham, M., Lovell, K., Rushton, K., Welsh, C., Brooks, H. L., Ardern, K., Bee, P., & Armitage, C. J. (2021) · Figshare · doi:10.6084/m9.figshare.14600584
Self-citation
- Authors
- Bee, P., Lovell, K., Airnes, Z., & Pruszynska, A.
- Affiliations
- University of Manchester (GB)
- Tameside and Glossop Integrated Care NHS Foundation Trust (GB)
- Corresponding author
- Bee, Penny
- Venue
- BMC Psychiatry
- Published
- 2016-03-01
- Volume
- 16
- Issue
- 1
- Pages
- 56-56
- ISSN
- 1471-244X (ISSN-L)
- PMC
- PMC4774117
- OpenAlex
- W2288883102
- Cited by
- 38
- References
- 35
- Citations by year
- 2025: 1 · 2024: 4 · 2023: 4 · 2022: 2 · 2021: 17 · 2020: 6 · 2019: 1 · 2018: 1 · 2017: 2
- FWCI
- 1.32
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- cc-by
- Locations
- BMC Psychiatry (publishedVersion, cc-by)
- Europe PMC (PubMed Central) (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Research Explorer (The University of Manchester) (publishedVersion, cc-by)
- Funders
- University of Derby
- National Institute for Health and Care Research (NF-SI-0512-10004)
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Telemedicine and Telehealth Implementation
- Social Sciences › Psychology › Applied Psychology › Digital Mental Health Interventions
- Health Sciences › Health Professions › General Health Professions › Health Policy Implementation Science
- Keywords
- therapist perspectives, Normalisation Process Theory, health technology implementation, access to mental health care, hard-to-reach populations, service integration
- MeSH terms
- Attitude of Health Personnel, Mental Disorders, Female, United Kingdom, Humans, Interviews as Topic, Male, Mental Health Services, Telephone, Cognitive Behavioral Therapy, Treatment Outcome, Telemedicine
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