Barriers and facilitators to providing CBT for people living with dementia: Perceptions of psychological therapists

Samatha Baker; Janina Brede; Rebecca Cooper; Georgina Charlesworth; Joshua Stott

doi:10.1002/cpp.2674

journal article Oct 20, 2021

Barriers and facilitators to providing CBT for people living with dementia: Perceptions of psychological therapists

Samatha Baker Janina Brede

Rebecca Cooper

Georgina Charlesworth

Joshua Stott

Clinical Psychology & Psychotherapy Vol. 29 No. 3 pp. 950-961 · Wiley

View at Publisher Save 10.1002/cpp.2674

Abstract

AbstractMany people living with dementia or mild cognitive impairment (MCI) experience anxiety and depression. Cognitive behavioural therapy (CBT) is a recommended treatment for adults, commonly provided through primary care psychological therapies services. This study explored the facilitators and barriers to providing CBT interventions for people living with dementia or MCI, as perceived by therapists working in such services.Structured interviews were conducted with 14 clinicians recruited through primary care psychological therapies services about their experiences of working with people living with dementia or MCI and their ideas about factors that enhance or hinder offering and delivering CBT to this population. Interview recordings were transcribed and analysed using thematic analysis. Credibility checks were incorporated throughout.Three themes were identified: ‘attitudes towards dementia’, ‘competing demands’, and ‘pressure without support’. Perceived facilitators and barriers occurred across individual, service, and system levels. Facilitators were positive engagement and outcomes for people living with dementia or MCI, positive attitudes of clinicians, and flexibility within some services. In contrast, perceived barriers were stigma towards dementia and mental health in older adults, high pressure on staff to perform with a lack of support to do so, exclusion based on diagnosis, and inflexibility within some services.Clinicians were confident that people living with dementia or MCI could benefit from CBT, with some adaptations to delivery. There are implications for staff support and training, and for commissioning practices relating to the tension between minimal resources, equitable access, and person‐centred care.

Topics

No keywords indexed for this article. Browse by subject →

References

45

[1]

10.1176/appi.books.9780890425596

[2]

10.1016/0165-0327(95)00072-0

[3]

10.1016/s0140-6736(11)60830-1

[4]

10.1191/1478088706qp063oa

[5]

10.1097/wad.0000000000000102

[6]

10.1111/bjhp.12475

[7]

10.1002/gps.4122

[8]

10.1177/0145445514561317

[9]

10.1016/j.jad.2018.04.110

[10]

10.1002/gps.4529

[11]

10.1111/jir.12274

[12]

10.3109/09540261.2011.606803

[13]

10.1192/bjb.2018.10

[14]

10.1002/da.22766

[15]

10.1348/014466599162782

[16]

10.3399/bjgp19x701297

[17]

10.5694/j.1326-5377.2004.tb05948.x

[18]

10.1177/1525822x05279903

[19]

10.1007/s00391-015-0898-8

[20]

10.1080/10503307.2017.1393575

[21]

10.1002/cpp.2190

[22]

10.1016/j.jagp.2017.09.006

[23]

10.1001/jamapsychiatry.2016.3162

[24]

10.1016/s0140-6736(17)31363-6

[25]

10.1186/s12877-020-01754-x

[26]

10.1111/jar.12328

[27]

10.1186/1472-6963-13-43

[28]

10.1111/j.1600-0447.2008.01326.x

[29]

10.1002/gps.4406

[30]

National Institute for Health and Care Excellence. (2018).Dementia: Assessment management and support for people living with dementia and their carers. NICE guideline [NG97].https://www.nice.org.uk/guidance/ng97/chapter/Recommendations#managing-non-cognitive-symptoms

[31]

National Institute for Health and Care Excellence. (2019).Suspected neurological conditions: recognition and referral. NICE guideline [NG127].https://www.nice.org.uk/guidance/ng127/chapter/Recommendations-for-adults-aged-over-16#memory-failure-and-cognitive-deterioration

[32]

NVivo (2018)

[33]

10.1192/bjp.bp.114.148130

[34]

Prince M. (2016)

[35]

10.1017/s104161021300152x

[36]

10.1371/journal.pone.0142388

[37]

10.1016/j.cpr.2008.02.008

[38]

10.1192/bjp.bp.113.140087

[39]

10.1016/j.jagp.2013.01.007

[40]

10.1016/j.neuropsychologia.2009.03.004

[41]

10.1016/j.jad.2020.07.088

[42]

10.1093/geronb/52b.4.p159

[43]

10.1177/1471301220915068

[44]

10.1080/09638237.2016.1276540

[45]

10.1111/j.1365-2796.2004.01380.x

Metrics

13

Citations

45

References

Details

Published: Oct 20, 2021
Vol/Issue: 29(3)
Pages: 950-961
License: View

Authors

S

Samatha Baker

Research Department of Clinical, Educational and Health Psychology University College London London UK

J

Janina Brede

Research Department of Clinical, Educational and Health Psychology University College London London UK

R

Rebecca Cooper

Research Department of Clinical, Educational and Health Psychology University College London London UK

G

Georgina Charlesworth

Research Department of Clinical, Educational and Health Psychology University College London London UK; Research and Development North East London NHS Foundation Trust (NELFT) Ilford UK

J

Joshua Stott

Research Department of Clinical, Educational and Health Psychology University College London London UK

Cite This Article

Samatha Baker, Janina Brede, Rebecca Cooper, et al. (2021). Barriers and facilitators to providing CBT for people living with dementia: Perceptions of psychological therapists. Clinical Psychology & Psychotherapy, 29(3), 950-961. https://doi.org/10.1002/cpp.2674

Barriers and facilitators to providing CBT for people living with dementia: Perceptions of psychological therapists

You May Also Like