Barriers and facilitators to engagement with between-session work for low-intensity Cognitive Behavioural Therapy (CBT)-based interventions: a qualitative exploration of practitioner perceptions

Abstract Background To address the growing demand for psychological treatment, healthcare providers are increasingly utilising low-intensity interventions, characterised by reduced practitioner contact and emphasis on independent patient engagement with therapeutic materials through between-session...

Full description

Saved in:
Bibliographic Details
Main Authors: Mia Bennion, Amy Blakemore, Karina Lovell, Penny Bee
Format: Article
Language:English
Published: BMC 2025-01-01
Series:BMC Psychiatry
Subjects:
Online Access:https://doi.org/10.1186/s12888-025-06501-3
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1832571484856385536
author Mia Bennion
Amy Blakemore
Karina Lovell
Penny Bee
author_facet Mia Bennion
Amy Blakemore
Karina Lovell
Penny Bee
author_sort Mia Bennion
collection DOAJ
description Abstract Background To address the growing demand for psychological treatment, healthcare providers are increasingly utilising low-intensity interventions, characterised by reduced practitioner contact and emphasis on independent patient engagement with therapeutic materials through between-session work (BSW). While BSW is critical for maximising treatment outcomes, patients and practitioners report challenges with its completion. Research identifying factors influencing between-session engagement in Cognitive Behavioural Therapy (CBT) has largely focused on high-intensity CBT, limiting understanding within low-intensity contexts. Methods This study explored practitioner perspectives on the barriers and facilitators of BSW engagement within low-intensity CBT-based interventions. Using interpretive description methodology, 22 Psychological Well-being Practitioners (PWPs) from UK National Health Service (NHS) Talking Therapies services were interviewed. Inductive and deductive framework analysis was used to crossmatch data to an existing conceptual model of predictors for CBT BSW engagement. Results Practitioners identified patient-level barriers including passive treatment expectations, comorbid health conditions, social stressors, and reduced mental health literacy, particularly among ethnic minority populations. Practitioner-level facilitators involved clear task planning and personalised BSW tailored to patients’ sociocultural environments. Organisational recommendations emphasised the need for diverse workforces and adequate training in culturally sensitive care. Conclusions Findings underscore the importance of practitioner behaviours in optimising patient engagement between-sessions, offering clear directions to enhance treatment outcomes in globally adopted low-intensity interventions.
format Article
id doaj-art-eb9524d71ed34fd89d1e6d05a7d63ed2
institution Kabale University
issn 1471-244X
language English
publishDate 2025-01-01
publisher BMC
record_format Article
series BMC Psychiatry
spelling doaj-art-eb9524d71ed34fd89d1e6d05a7d63ed22025-02-02T12:35:56ZengBMCBMC Psychiatry1471-244X2025-01-0125111610.1186/s12888-025-06501-3Barriers and facilitators to engagement with between-session work for low-intensity Cognitive Behavioural Therapy (CBT)-based interventions: a qualitative exploration of practitioner perceptionsMia Bennion0Amy Blakemore1Karina Lovell2Penny Bee3Division of Nursing, Midwifery and Social Work, The University of ManchesterDivision of Nursing, Midwifery and Social Work, The University of ManchesterDivision of Nursing, Midwifery and Social Work, The University of ManchesterDivision of Nursing, Midwifery and Social Work, The University of ManchesterAbstract Background To address the growing demand for psychological treatment, healthcare providers are increasingly utilising low-intensity interventions, characterised by reduced practitioner contact and emphasis on independent patient engagement with therapeutic materials through between-session work (BSW). While BSW is critical for maximising treatment outcomes, patients and practitioners report challenges with its completion. Research identifying factors influencing between-session engagement in Cognitive Behavioural Therapy (CBT) has largely focused on high-intensity CBT, limiting understanding within low-intensity contexts. Methods This study explored practitioner perspectives on the barriers and facilitators of BSW engagement within low-intensity CBT-based interventions. Using interpretive description methodology, 22 Psychological Well-being Practitioners (PWPs) from UK National Health Service (NHS) Talking Therapies services were interviewed. Inductive and deductive framework analysis was used to crossmatch data to an existing conceptual model of predictors for CBT BSW engagement. Results Practitioners identified patient-level barriers including passive treatment expectations, comorbid health conditions, social stressors, and reduced mental health literacy, particularly among ethnic minority populations. Practitioner-level facilitators involved clear task planning and personalised BSW tailored to patients’ sociocultural environments. Organisational recommendations emphasised the need for diverse workforces and adequate training in culturally sensitive care. Conclusions Findings underscore the importance of practitioner behaviours in optimising patient engagement between-sessions, offering clear directions to enhance treatment outcomes in globally adopted low-intensity interventions.https://doi.org/10.1186/s12888-025-06501-3Cognitive behavioural therapy (CBT)Low-intensity interventionsPatient engagementBetween-session work (BSW)Qualitative
spellingShingle Mia Bennion
Amy Blakemore
Karina Lovell
Penny Bee
Barriers and facilitators to engagement with between-session work for low-intensity Cognitive Behavioural Therapy (CBT)-based interventions: a qualitative exploration of practitioner perceptions
BMC Psychiatry
Cognitive behavioural therapy (CBT)
Low-intensity interventions
Patient engagement
Between-session work (BSW)
Qualitative
title Barriers and facilitators to engagement with between-session work for low-intensity Cognitive Behavioural Therapy (CBT)-based interventions: a qualitative exploration of practitioner perceptions
title_full Barriers and facilitators to engagement with between-session work for low-intensity Cognitive Behavioural Therapy (CBT)-based interventions: a qualitative exploration of practitioner perceptions
title_fullStr Barriers and facilitators to engagement with between-session work for low-intensity Cognitive Behavioural Therapy (CBT)-based interventions: a qualitative exploration of practitioner perceptions
title_full_unstemmed Barriers and facilitators to engagement with between-session work for low-intensity Cognitive Behavioural Therapy (CBT)-based interventions: a qualitative exploration of practitioner perceptions
title_short Barriers and facilitators to engagement with between-session work for low-intensity Cognitive Behavioural Therapy (CBT)-based interventions: a qualitative exploration of practitioner perceptions
title_sort barriers and facilitators to engagement with between session work for low intensity cognitive behavioural therapy cbt based interventions a qualitative exploration of practitioner perceptions
topic Cognitive behavioural therapy (CBT)
Low-intensity interventions
Patient engagement
Between-session work (BSW)
Qualitative
url https://doi.org/10.1186/s12888-025-06501-3
work_keys_str_mv AT miabennion barriersandfacilitatorstoengagementwithbetweensessionworkforlowintensitycognitivebehaviouraltherapycbtbasedinterventionsaqualitativeexplorationofpractitionerperceptions
AT amyblakemore barriersandfacilitatorstoengagementwithbetweensessionworkforlowintensitycognitivebehaviouraltherapycbtbasedinterventionsaqualitativeexplorationofpractitionerperceptions
AT karinalovell barriersandfacilitatorstoengagementwithbetweensessionworkforlowintensitycognitivebehaviouraltherapycbtbasedinterventionsaqualitativeexplorationofpractitionerperceptions
AT pennybee barriersandfacilitatorstoengagementwithbetweensessionworkforlowintensitycognitivebehaviouraltherapycbtbasedinterventionsaqualitativeexplorationofpractitionerperceptions