Understanding clinician attitudes towards implementation of guided self-help cognitive behaviour therapy for those who hear distressing voices: using factor analysis to test normalisation process theory

Hazell, Cassie M, Strauss, Clara, Hayward, Mark and Cavanagh, Kate (2017) Understanding clinician attitudes towards implementation of guided self-help cognitive behaviour therapy for those who hear distressing voices: using factor analysis to test normalisation process theory. BMC Health Services Research, 17 (507). pp. 1-9. ISSN 1472-6963

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Abstract

Background

The Normalisation Process Theory (NPT) has been used to understand the implementation of physical health care interventions. The current study aims to apply the NPT model to a secondary mental health context, and test the model using exploratory factor analysis. This study will consider the implementation of a brief cognitive behaviour therapy for psychosis (CBTp) intervention.

Methods

Mental health clinicians were asked to complete a NPT-based questionnaire on the implementation of a brief CBTp intervention. All clinicians had experience of either working with the target client group or were able to deliver psychological therapies. In total, 201 clinicians completed the questionnaire.

Results

The results of the exploratory factor analysis found partial support for the NPT model, as three of the NPT factors were extracted: (1) coherence, (2) cognitive participation, and (3) reflexive monitoring. We did not find support for the fourth NPT factor (collective action). All scales showed strong internal consistency. Secondary analysis of these factors showed clinicians to generally support the implementation of the brief CBTp intervention.

Conclusions

This study provides strong evidence for the validity of the three NPT factors extracted. Further research is needed to determine whether participants’ level of seniority moderates factor extraction, whether this factor structure can be generalised to other healthcare settings, and whether pre-implementation attitudes predict actual implementation outcomes.

Item Type: Article
Keywords: Normalisation process theory – Implementation – Questionnaire – CBTp – CBTv – Psychosis – Hearing voices – Auditory hallucinations – Self-help – IAPT
Schools and Departments: School of Psychology > Psychology
Brighton and Sussex Medical School > Primary Care and Public Health
Depositing User: Ellena Adams
Date Deposited: 21 Aug 2017 11:40
Last Modified: 28 Sep 2017 14:30
URI: http://sro.sussex.ac.uk/id/eprint/69890

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