Low Intensity Help for Depression under
Spotlight
Psychologists at Massey University are
investigating whether a form of low intensity psychological
intervention, which has been successful in England, could be
adapted to New Zealand to help thousands suffering
depression and less severe mental health conditions.
The
model centres on reducing specialist mental health
practitioner time by using a variety of guided self-help
interventions, which can be delivered in a variety of
formats such as self-help books or internet programmes.
Secondly, it employs specially trained, low intensity
practitioners as a guides and supporters.
Low Intensity
Cognitive Behavioural Therapy, as it is known, aims to help
people with mild to moderate mental health problems who
might find it difficult to access state-supported mental
health services. The service can be offered from community
centres, halls or libraries as a way of improving access and
helping to de-stigmatise mental health issues and
treatment.
The main purpose of the approach is to increase
access to evidence-based psychological interventions to the
growing number of people suffering from mild to moderate
mental health problems, without substantially increasing the
cost of treatment, says Dr Beverly Haarhoff. She and
colleagues Dr Mei Williams and Dr Angela McNaught, senior
lecturers based at Massey’s School of Psychology, are
investigating whether the new therapy model could be used
here. They are currently researching and writing a series of
articles on the topic for a special section of the New
Zealand Journal of Psychology, to be published
mid-year.
Key components of the approach – which was
developed from the Cognitive Behavioural Therapy (CBT) model
– is the introduction of a new kind of practitioner (a
Psychological Wellbeing Practitioner or PWP), requiring a
different type of training and supervision.
“The use of
therapy resources, such as guided self-help (written or
internet), giving more choice and flexibility to the client
in the form of different delivery modes (group, individual,
telephone, internet), and using language in a way which
makes the principles of CBT more understandable to the
client are also at the heart of the model,” says Dr
Haarhoff. “There is also a focus on prevention, thus an
emphasis on psychological education.”
While some
Psychological Wellbeing Practitioners in England come from a
background working in mental health, not all are recruited
from the traditional mental health professional training
programmes such as those undertaken by psychologists and
psychotherapists, she says.
“Theoretically, they
come from many walks of life outside of what would be
historically be identified as mental health
professionals.”
Recruiting and training people from
diverse cultural and ethnic backgrounds who can communicate
authentically with people from their own socio-cultural
groups is another factor in the success of the model, she
says.
Dr Williams says with an increasingly diverse
demographic in New Zealand, the model could be structured to
meet the needs of vulnerable groups traditionally less
likely to access mental health services, such as Māori and
Pasifika, Asian and other new migrant groups, as well as
youth, the elderly and people in rural communities.
Two
doctoral research projects completed by Massey psychology
students have already looked at the impact of low intensity
therapy in individual and group formats, and a master’s
study by a Taiwanese student has trialled its’
effectiveness with international students seeking help for
anxiety and depression.
While the cost of the therapy is
free to clients in the England through the National Health
Service, it is not intended simply as a budget version of
more complex and comprehensive therapies, says Dr Williams.
Like any legitimate mental health service, it involves
managed supervision of cases and clients to ensure high
quality, ethical care standards are maintained across a
nation-wide service.
According to the Mental Health
Foundation’s 2011/2012 survey, 14.3 per cent of New
Zealand adults (more than half a million people) had been
diagnosed with depression at some time in their lives, and
6.1 per cent (more than 200,000 people) with anxiety
disorders (including generalised anxiety disorder, phobias,
post-traumatic stress disorder and obsessive-compulsive
disorder).
Dr Williams says three per cent of those with
mental health conditions suffer moderate to severe symptoms
and are treated in the hospital system, while some of those
with low to moderate problems seek help through their GPs or
a range of counselling
services.
ENDS