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Applying psychological models of psychosis and working with cultural diversity

Gordon, L. E. (2005). Applying psychological models of psychosis and working with cultural diversity. (Unpublished Doctoral thesis, City, University of London)


Specific psychosocial treatments have been shown to be effective with people suffering from severe mental illness. Access to psychosocial treatments: cognitive- behavioural therapy (CBT) and family interventions (FIs) is considered paramount for every mental health service user with a diagnosis of schizophrenia/schizoaffective disorder and their carers (NHS Executive, 2000). This study aimed to explore and describe the views of service users, carers and mental health professionals regarding barriers to accessing CBT and FIs for people with medication-non- responsive schizophrenia/schizoaffective disorder and their carers.

The following were target groups for this research: services users; carers and mental health professionals. In order to meet inclusion criteria, service users were required to have at least one positive symptom of psychosis which had been unremitting for 6 months. Carers were required to be 18 years or older and caring for someone suffering from schizophrenia/schizoaffective disorder. Carers were also required to have a minimum of 10 hours of direct contact with the service user per week. It was requisite that mental health professionals were working within the particular mental health Trust under study. The design involved collating data from focus group discussions and individual semi-structured interviews. Focus group questions were constructed to elicit descriptions of the following: how participants viewed the treatments available in the Trust; their beliefs about the barriers service users and carers faced in terms of accessing CBT and FIs; and views on how things might be improved. The semi-structured interview questions addressed the following topics: Awareness; Skill mix; Culture and ethnicity; Religion; Age; Gender; Sexuality; Resources; Mental health diagnosis; and Physical disability. Grounded Theory analysis of the data led to the emergence of five barriers, namely: Dominance of the medical model; Mistrust; Service hostility; Perception of the service as ‘elitist’; and Information and communication. There were also methods of Overcoming barriers that emerged. The accounts of barriers differed for service users, carers and mental health professionals in terms of their complexity and impact. This research contributes to illuminating the multiplicity of barriers to accessing CBT and FIs for service users and their carers.

Publication Type: Thesis (Doctoral)
Subjects: B Philosophy. Psychology. Religion > BF Psychology
Departments: School of Health & Psychological Sciences > Psychology
School of Health & Psychological Sciences > School of Health & Psychological Sciences Doctoral Theses
Doctoral Theses
[thumbnail of Gordon thesis 2005 PDF-A.pdf]
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