Factors that influence the uptake and continuing practice of Interpersonal Psychotherapy by frontline mental health clinicians following formal training

Interpersonal Psychotherapy (IPT) was initially developed by Gerald Klerman and colleagues in 1968 as a time limited treatment for depression in a research setting. Since then international empirical studies have proved IPT to be an effective treatment for a wide age range of patients, from differing cultural groups, in a variety of psychiatric conditions such as affective disorders, Markowitz and Weissman (2004), anxiety disorders, Lipsitz, Markowitz, Cherry & Fyer (1999) and eating disorders, Agras, Walsh, Fairburn, Wilson & Kraemer (2000). Providing access to evidence based treatment is a focus of New Zealand mental health guidelines, and recommendations have been made for the dissemination and implementation of talking therapies throughout the sectors of New Zealand mental health care (Te Pou., 2007, 2009, 2012). Interpersonal Psychotherapy is one of the few recommended therapies. A review of emergent literature had identified a gap in current research specifically investigating factors that influence the uptake of IPT by mental health clinicians in New Zealand. However, international studies show the uptake of evidence based treatments like IPT by frontline clinicians following training can be variable (Paley, Shapiro, Myers, Patrick & Reid, 2003), (Reay, Stuart & Owen, 2003), and (Sin & Scully, 2008). Te Pou., (2012) concluded that there is variability of access to talking therapies in New Zealand, and that this must be addressed to meet demand by 2020. This small study examined factors that influence the uptake and continuing practice of IPT, by frontline clinicians following training. Purposive sampling identified three cohorts of Post Graduate IPT students from Otago University who were at year one, year three, and year six post training, from which eight students consented to participate in the research. Applying Interpretative Phenomenological Analysis methods, semi-structured recorded interviews explored the participants’ personal experiences to understand the individual experiences of clinicians before, during and after training as IPT therapists, in order to explore what aspects of these experiences may have influenced their decisions related to practising IPT, and the extent to which these clinicians have continued to use IPT in routine clinical practice. Demographic data and a research diary provided additional contextual data. The qualitative data was analysed progressively, first from an idiographic perspective, generating emerging themes from individual interviews, and then searching for convergence and divergence in the emergent themes across the groups of participants. The data was drawn together in a structured format and the findings were presented in an interpretative narrative summary, evidenced by extracts from the original data. This information was then integrated with the demographic data. In the discussion three factors that may influence the implementation and dissemination of IPT were highlighted. The first factor being core and post graduate training in psychological interventions, the second related to the involvement of supportive multi-disciplinary teams committed to the practice and supervision of PSIs, and the third area was the impact of role perception on the participants’ ability to practice psychological interventions. The research concluded with suggestion for potential future research in the areas of training, team development and role definition