Groups for Specific vs Mixed Diagnosis Patients of Chronic Conditions

Summary

Does a group programme already delivered in routine practice to patients who share a diagnosis from the same medical speciality (i.e. specific-diagnosis) show equal effectiveness when modified for patients with diagnoses from a range of medical specialities (i.e. mixed-diagnosis)?

A large number of people live with a long-term condition (LTC) and the burden of living with a LTC is recognised on a societal and individual level. Links between LTCs and poorer mental health increase demand on psychological services. Consequently new initiatives try to reduce waiting times and increase the capacity of these services. Group programmes use resources efficiently and have been applied across a range of medical specialities. A clinical health psychology service has adopted a group programme based on a well evidenced psychological therapeutic approach called Acceptance and Commitment Therapy (ACT), for patients with dermatology conditions showing promising outcomes. However, the investigators want to compare whether similar outcomes can be achieved with patients from a range of specialities.

The investigators conducted quantitative and qualitative research to answer the research questions a) Does an Acceptance and Commitment Therapy group intervention for specific-diagnosis groups suggest similar effectiveness in health-related quality of life, illness beliefs and psychological distress versus mixed-diagnosis groups? b) Is there a difference in feasibility and acceptability of an Acceptance and Commitment Therapy intervention between specific-diagnosis groups versus mixed-diagnosis groups? c) What are health professionals' views on the acceptability and feasibility of specific-diagnosis versus mixed-diagnosis groups and their experiences of working with patients who have attended such groups?

Participants were recruited from the Clinical Health Psychology waiting list at a UK NHS Trust. Participants attended 7, two-hour weekly sessions and an 8 week follow-up 'reunion', and completed health related quality of life, illness perceptions, depression and anxiety questionnaires pre and post intervention. Patient participants and health professional participants (facilitators and referrers) were invited to attend focus groups to discuss their views and experiences.

Conditions

• Diabetes
• Cardiovascular Diseases
• Skin Diseases
• Rheumatic Diseases
• Mental Health Issue

Interventions

OTHER

Acceptance and Commitment Therapy Group Intervention

The intervention consists of 7, 2-hour weekly sessions. Session 1 focused on introductions, outlining sessions and sharing experiences. Session 2 introduced key techniques used in the psychological approach (ACT) including mindfulness and understanding difficult thoughts and feelings. Session 3 explored ideas of primary and secondary suffering and reviewed the workability of current coping strategies. Session 4 asked participants to clarify their own personal values. Session 5 focused on goal setting and utilising problem solving skills. Session 6 considered barriers to change including assertiveness communication skills. Session 7 reviewed topics covered over the 6 weeks previously and explored pacing and preparing for setbacks. Finally a follow up 8 weeks later brought participants back for a reunion to review progress with goals and offer an opportunity to address any ongoing issues.

Sponsors & Collaborators

• University of Stirling

  lead OTHER

Principal Investigators

• Holly Martin-Smith · University of Stirling

Eligibility

Min Age

18 Years

Sex

ALL

Healthy Volunteers

Yes

Timeline & Regulatory

Start

2020-06-01

Primary Completion

2021-09-30

Completion

2021-11-30

Countries

• United Kingdom

Study Locations