Delivering Contemporary CBT Interventions to Unemployed and Working Populations: Prevention, Retention, and Rehabilitation

Lead Research Organisation: City University London
Department Name: Sch of Social Sciences

Abstract

This follow-on project is designed to provide four partner organisations with the knowledge and skills to deliver group-based psychological interventions based on the principles and practices of acceptance and commitment therapy (ACT). ACT is a modern form of cognitive-behavioural therapy, which provides clients with a combination of mindfulness and behavioural activation skills. The project follows-on from an earlier ESRC-funded research project, which demonstrated the effectiveness and efficiency of a brief group-based version of ACT for improving people's mental health, behavioural functioning, and life satisfaction. The project partners were closely involved in the design of this follow-on work, and include a local branch of Mind (a mental health charity), and staff support/ occupational health professionals from three separate NHS Trusts. In the first phase of the project, the Principal Investigator (PI; Dr. Paul Flaxman, City University London) will directly train several staff support psychologists, counsellors, and vocational rehabilitation specialists in how to deliver ACT in groups. These partners will then be supported and observed by the PI as they begin cascading ACT-based training down to their service users. The results and impact of the project will be communicated to a wider group of stakeholders at a feedback workshop held towards the end of the nine month project (this event will be co-facilitated by the PI and the project partners). The ultimate aims of the project are to: 1) enhance the project partners' staff and employment support service provision; 2) offer help to NHS employees experiencing common mental health problems; 3) improve the psychological well-being and behavioural functioning of individuals accessing local mental health and employment support services; and 4) provide much wider access to ACT interventions than has previously been possible.

Planned Impact

Who will benefit?

The most immediate beneficiaries of this follow-on project will be the psychologists, counsellors, psychological well-being practitioners, and employment support specialists who will be trained to deliver ACT interventions by the Principal Investigator (Dr. Paul Flaxman, City University London). These various professionals are employed by the four project partners: a regional branch of the UK's leading mental health charity (Mind), and the staff support functions within three separate NHS Trusts.

These professionals will then be supported and observed by the PI as they cascade ACT interventions down to their own staff groups and service users. These service user beneficiaries include: 1) NHS managers who are reporting difficulties "switching off" from work during their leisure time; 2) NHS staff members who are experiencing a common mental health problem (and who are considered at risk of stress-related sickness absence); 3) NHS staff groups being exposed to ongoing and significant organisational change; and, 4) unemployed (and long term absent) individuals who are accessing psychological and vocational support services in the South East of England.

More indirect beneficiaries include providers of staff support and mental health services from around the UK, who will be invited to a feedback and dissemination workshop towards the end of this nine month project. This event will be co-hosted by the PI and the project partners, and will include input from a sample of the aforementioned service users.

How will they benefit?

The project partners will benefit by receiving training from an internationally recognised expert in delivering ACT interventions to heterogeneous groups of individuals (e.g., Flaxman & Bond, 2006; 2010b; 2010c). The partner teams will receive the equivalent of three full days of training in ACT, plus follow-up supervision and observation support from the PI as they begin offering ACT workshops to their own service users. In this way, it is expected that the project partners will develop sufficient expertise to continue independently delivering ACT interventions long after this project has been completed. A strong argument in favour of this continuation project is that it will enhance the project partners' current service provision.

The partners' service users will benefit by having unprecedented access to an empirically supported intervention that has been shown to provide clinically meaningful improvements in people's mental health (Flaxman & Bond, 2010c). The proposed follow-on activities include offering ACT-based training to general NHS staff groups, as well as targeting particular groups in need of more immediate support (e.g., those held on waiting lists for psychological services). There is clearly an urgent need to increase access to evidence-based psychological interventions. For example, a recent review estimated that around three-quarters of employees with a common mental health problem do not receive a recognised intervention (Seymour & Grove, 2005).

Timescales for Impact

As indicated in the attached workplan, the PI will begin training the project partner teams within the first few weeks of the project's proposed start date (3rd September 2012). As soon as they have completed the training, these professionals will be supported by the PI as they begin offering the training to service users. By the end of the nine month project, it is expected that all four project partner teams will have offered a complete ACT intervention to groups of staff and service users. The number of people trained will then continue to be monitored for a further 12 months to feed into the final impact report.

The dissemination workshop will be held in the final month of the project. This will allow the PI and his collaborators to evaluate the impact of the project, and prepare to publicise to a wider group of professional stakeholders and mental health service providers.

Publications

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Curtin, A (2014) Irish Psychologist

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Jennings T. (2016) Meaninful work in Counselling at Work

 
Description Impact Case Study: Application of an Evidence-Based Intervention for Improving Employees' Mental Health
Geographic Reach Multiple continents/international 
Policy Influence Type Influenced training of practitioners or researchers
Impact This case study describes the impact generated by Dr Paul Flaxman's research in the Department of Psychology at City University London. Flaxman has taken a prominent role in designing a psychological skills training programme that is based on recent developments in the field of psychotherapy. The training has been adopted and utilised by a range of organisations, including Northumbria Healthcare Trust; Central Manchester Foundation Trust; Camden and Islington NHS Foundation Trust; and the South London and Maudsley Mental Health Trust. Other beneficiaries include the City and Hackney branch of Mind (the mental health charity) and nurse training providers at Middlesex University. International reach is evidenced by the adoption of the training for supporting psychiatric nurses working in Uganda. Data collected from over 600 British employees indicate that the training leads to significant and sustained improvements in people's mental health. The training has been shown to be particularly beneficial for employees experiencing a common mental health problem such as anxiety or depression.
URL http://impact.ref.ac.uk/CaseStudies/CaseStudy.aspx?Id=44349
 
Description City and Hackney MIND 
Organisation MIND (Mental Health Charity)
Country United Kingdom 
Sector Charity/Non Profit 
PI Contribution Successful joint funding application to Trust for London. Funding for new project to assess the impact of intervention based on acceptance and commitment therapy (ACT) for supporting employees with a common mental health problem.
Collaborator Contribution Jointly wrote funding application to secure funding. Build directly on ESRC follow-on grant activities.
Impact £4000 funding awarded to Dr. Paul Flaxman through Mind (awarded body is Trust for London). Rest of grant (£40,000) awarded to Mind to pay for project manager salary for one year.
Start Year 2014
 
Description Parliamentary roundtable on mindfulness in the workplace 
Organisation Mindfulness Initiative
Country United Kingdom 
Sector Charity/Non Profit 
PI Contribution Contribution to Parliamentary roundtable on mindfulness in the workplace, chaired by prominent journalist (Guardian) and MPs.
Collaborator Contribution Communication of Dr. Flaxman's ESRC funded research supporting use of ACT interventions in the workplace
Impact Invitation to deliver ACT workshop at Mindfulness at Work conference hosted by Cranfield University
Start Year 2014
 
Description Acceptance and commitment training (ACT) in the workplace : a three-session protocol 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach Regional
Primary Audience Professional Practitioners
Results and Impact BABCP ACT Network Event, Slides showing the ACT intervention protocol that was evaluated in this research

Post workshop[ conversations with NHS practitioner led to further funding for Guy's and St. Thomas' charitable trust
Year(s) Of Engagement Activity 2012,2013,2014
 
Description January 2010 
Form Of Engagement Activity A magazine, newsletter or online publication
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Professional Practitioners
Results and Impact Summary of project/ recovery research from an associate of the NHS research programme (Jan Hill-Tout), Organisational Health newsletter distributed to NHS staff

Information on research sent to NHS partners' practitioner network
Year(s) Of Engagement Activity 2010
 
Description Mindfulness at Work Conference invited workshop 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact Received follow-up contact form conference delegates. Paul Flaxman's book (The Mindful and Effective Employee) highlighted in Conference opening presentation

Increased interest in book (The Mindful and Effective Employee
Year(s) Of Engagement Activity 2014
URL http://www.mindfulnet.org/page39.htm
 
Description Promoting the psychological well-being of NHS staff 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach Regional
Primary Audience Professional Practitioners
Results and Impact Presentation to NHS workforce committee, London. Slides from presentation delivered to workforce committee at Northumbria Healthcare Trust.

Intervention cascaded to over 100 NHS staff
Year(s) Of Engagement Activity 2011
 
Description Stakeholder workshop on acceptance and commitment therapy 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? Yes
Geographic Reach National
Primary Audience Professional Practitioners
Results and Impact Requests for further training

Generated interest in Dr. Paul Flaxman's book: The Mindful and Effective Employee. Resulted in further ACT training being offered at City University London.
Year(s) Of Engagement Activity 2013
URL http://www.google.co.uk/url?sa=t&rct=j&q=&esrc=s&source=web&cd=7&ved=0CEIQFjAG&url=http%3A%2F%2Fxa.y...
 
Description Workshop invitation 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact Invited workshop at UK ACT/ Contextual Behavioural Science conference, Dublin December 2014

Invited to contribute to article published in the Irish Psychologist. ('Applications of Acceptance and
Commitment Therapy and Contextual Behavioural Science: A Primer'. Irish Psychologist, October 2014, Volume 40, Issue 12).
Year(s) Of Engagement Activity 2014
URL http://www.actcbsconference.com/venue.php