Do primary care psychological therapists 'think family'? Challenges and opportunities for couple and family therapy in the context of 'Improving Access to Psychological Therapies' (IAPT) services

摘要

Very little couple or family work takes place in primary care despite the advantages offered by the context. This pilot study investigated the experiences of primary care adult therapists regarding the place of families in their clinical work. Semi-structured interviews with seven therapists were analysed using interpretative phenomenological analysis. The findings tentatively suggest that primary care psychological therapists 'think family' primarily from the perspective of their main therapeutic model when offering individual therapy. Some study participants questioned the appropriateness of their family/context focus. Family members were extremely rarely seen together. Facilitating factors included supervision and training. Barriers to family work were both external (the work setting) and internal (beliefs about it). The impact of the current dominance of cognitive behavioural therapy in National Health Service adult psychological therapy services and the development of Improving Access to Psychological Therapies (IAPT) services on the provision of couple and family therapy are discussed. Some challenges and opportunities presented by IAPT for couple and family therapy are explored.