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Improving access to psychological therapy for people with learning disabilities from services users' and clinicians' perspectives: An action research approach

Bexley, Kate (2017). Improving access to psychological therapy for people with learning disabilities from services users' and clinicians' perspectives: An action research approach. (Unpublished Doctoral thesis, City, University of London)


Background: Despite legislation commanding equitable access to all mainstream services, reports continue to question Improving Access to Psychological Therapies (IAPT) accessibility for people with learning disabilities (LD). Related research typically excludes service-users with LD perspectives’ and overlooks implementation of findings. This research aimed to elicit, implement and evaluate IAPT service users with LD and IAPT clinicians’ suggestions for improvement regarding the accessibility of one IAPT service.

Method: An action research design comprised of: planning/data gathering (phase one), action/implementation (phase two) and evaluation (phase three) was undertaken within an inner-London IAPT service. Seven IAPT service-users with LD and 12 IAPT clinicians were interviewed using a revised version of the Green Light Toolkit (National Development Team for Inclusion, 2013). Qualitative data from phases one and three were analysed using thematic analysis. Phase one recommendations were collaboratively implemented over a six-month period in phase two. Phase three consisted of evaluative interviews with service-users with LD and IAPT clinicians and elicitation of further recommendations.

Results: Phase one found both service-users’ and clinicians’ believed that the service was ‘doing well’. Both also proposed recommendations for clinician and recommendations for the service. However, clinicians’ recommendations were underpinned by their ‘uncertainty’ in working with this population. Phase two’s implementation of recommendations included: adaptations of existing written texts, creation and distribution of easy read promotional material on IAPT, and three training events. Phase three saw both groups commend the actions taken and propose further recommendations for clinicians and for the service; however, clinician’s continued to express doubts about whether IAPT could fully adapt without systemic changes.

Conclusion: Whilst effective changes can be made ‘on the ground’, in order for people with LD to receive equitable access and adequate support within IAPT, ‘LD’ needs to be prioritised by IAPT commissioners, service leads, and training course providers. This project is particularly relevant for Counselling Psychologists as it embodies the requirement for us learn from and work with service users and other professionals, attend to discrimination and work towards social justice.

Publication Type: Thesis (Doctoral)
Subjects: B Philosophy. Psychology. Religion > BF Psychology
Departments: School of Health & Psychological Sciences > Psychology
Doctoral Theses
Doctoral Theses > School of Arts and Social Sciences Doctoral Theses
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