Improving Public Mental Health Service: Is Group Therapy the Answer?

Improving Public Mental Health Service: Is Group Therapy the Answer?

Several psychotherapeutic varieties exist and can be delivered either individually or in a group format. Group Therapy is an effective treatment modality however, there is limited evidence related to the implementation and sustainability of a Therapeutic Group Program (TGP) in an Australian public mental health service setting. The aim of this work-based study was to identify and understand critical elements contributing to the sustainability of a TGP and to enable scaling of implementation in other services. A retrospective analysis of a TGP provided the opportunity to conduct a retrospective analysis of implementation. The TGP consisted of a variety of group therapies for example Dialectical Behaviour Therapy, Cognitive Remediation, Cognitive Behaviour Therapies. Case managers, consumers (patients) and management’s perceptions of the barriers and facilitators of TGP implementation were collected via 14 semi-structured interviews. Michie’s Behaviour Change Wheel characterising behaviour change interventions through Capability, Motivation, Opportunity, and Behaviour (COM-B) was utilised for the thematic analyses of the qualitative data. The findings identified the following: Capability: a shift in focus from case management towards therapeutic intervention and specific training programs leading towards participation in the TGP leads to improved staff capability; Motivation: a clear well defined structured evidence-based approach is required as well as opportunities for staff to participate in the TGP as this facilitate enhanced work satisfaction due to staff working to their full scope of practice; and Opportunity: management support, allocated staff, allotted time for staff, adequate resourcing including a specific budget and clear governance structures are required to sustain the TGP. Strategies identified to facilitate the implementation of evidence-based practice included behaviour change interventions and clarity in statements of policy requirements and governance processes related to TGP in policy documents. These strategies would enable to implementation of a TGP within a public mental health setting and provide consumers access to group therapy through a public service.

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