No abstract

Objective: To investigate the barriers and facilitators of an effective implementation of an outcome monitoring and feedback system in a UK National Health Service psychological therapy service. Method: An outcome monitoring system was introduced in two services. Enhanced feedback was given to therapists after session 4. Qualitative and quantitative methods were used, including questionnaires for therapists and patients. Thematic analysis was carried out on written and verbal feedback from therapists. Analysis of patient outcomes for 202 episodes of therapy was compared with benchmark data of 136 episodes of therapy for which feedback was not given to therapists. Results: Themes influencing the feasibility and acceptability of the feedback system were the extent to which therapists integrated the measures and feedback into the therapy, availability of administrative support, information technology, and complexity of the service. There were low levels of therapist actions resulting from the feedback, including discussing the feedback in supervision and with patients. Conclusions: The findings support the feasibility and acceptability of setting up a routine system in a complex service, but a number of challenges and barriers have to be overcome and therapist differences are apparent. More research on implementation and effectiveness is needed in diverse clinical settings.

MBCT may contribute to change in individuals' perceptions and increase self-understanding. The study highlights the importance of measuring change in recovery following MBCT. Findings support the need for person-centred approaches to assessment and monitoring of personal change following therapy. Similar studies using a control group are needed in order to identify whether the changes found are attributable to participation in an MBCT group. Copyright © 2015 John Wiley & Sons, Ltd.

Staff viewed mindfulness groups for psychosis as helpful, not harmful, but were uncertain about their utility. Consistent with previous research, service users viewed mindfulness groups as useful to promote well-being and reduce distress for individuals experiencing psychosis.

An audit conducted within the psychology department of a medium secure unit identified how psychologists spent their time at work. Indirect clinical work took up much of the psychologists’ time. Direct client contact accompanied a significant amount of preparatory/report-writing work.