Clients’ experiences of one-to-one low-intensity interventions for common mental health problems : an interpretative phenomenological analysis

Objectives: Common mental health disorders such as depression and anxiety are highlyprevalent and carry significant health care and economic burdens. The UK’s improvingaccess to psychological therapies (IAPT) initiative was developed as a cost-effective way ofreducing the pernicious effects of these disorders. IAPT interventions, such as guidedself-help, have been subjected to considerable quantitative evaluation. However, therehas been minimal investigation into clients’ experiences of the one-to-one low-intensityinterventions (LIIs), which form a key component of IAPT service provision. Qualitativeexploration could provide rich data regarding experiences of psychological change andfactors affecting therapeutic experiences. This will enable informative, client led insightsinto how low-intensity therapy can be improved. Methods: Interpretative phenomenological analysis of eight semi-structured interviewswas used to develop an idiosyncratic understanding of clients’ experiences of one-to-oneLIIs following entry into a randomized control trial (RCT). Results: Four superordinate themes were identified from clients’ accounts: goals andexpectations of therapy, beneficial aspects of therapy, non-beneficial aspects of therapy,and the experience of psychological change. A heuristic model of interrelationshipsbetween factors is proposed. Conclusions: Both therapeutic techniques and relationships contribute to beneficialtherapeutic experiences. The results reported here can be used to inform practice byharnessing the most beneficial aspects of therapy, such as developing adaptive therapeuticapproaches to clients’ clinical needs and facilitating idiosyncratic processes of psychologicalchange. Due to limited qualitative research in this area, further research should be conductedin different service settings to assess differences and similarities in clients’ experiences