Preparing for cognitive behavioural therapy: a Delphi exercise to develop a consensus curriculum

认知行为疗法准备:通过德尔菲法制定共识课程

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Abstract

AIM: To develop a consensus curriculum describing what information service users should be given prior to cognitive behavioural therapy (CBT). DESIGN: A Delphi study was undertaken. Following development work with professionals and experts by experience, 30 initial statements were prepared and survey rounds were undertaken until 90% of statements achieved 80% consensus on inclusion or exclusion. SETTING: NHS Talking Therapies services in England provide CBT following referral by a professional or self-referral. Out of 1.7 million referrals in 2022-2023 more than 1 million disengaged before or during therapy. Ensuring patients are adequately prepared for CBT is one promising approach to improving engagement and outcomes. PARTICIPANTS: Participants were only included if they had either 3 years of clinical experience in NHS Talking Therapies services or a leadership role in NHS Talking Therapies services. They reported current employment at seven NHS Trusts in England as well as private practice. RESULTS: Of the 41 participants, 36 completed all three rounds. After three rounds, 27 statements were included by consensus in the curriculum, covering six domains: Emergency information (two statements), What is CBT? (six statements), Practical preparation for CBT (five statements), What does a CBT session look like? (five statements), What is CBT not? (two statements) and How can people get the most out of CBT? (seven statements). CONCLUSIONS: This consensus curriculum provides a basis for ensuring patients are well-prepared for CBT within the context of NHS Talking Therapies. Further research on improving engagement and outcomes from NHS Talking Therapies services should aim to address these 27 topics.

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