The Prospect Model

Strands in Development

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IPT-Self Guided

6 week self-guided booklet that follows the principles of IPC aimed at reducing symptoms of mild distress.  This can be worked on at the individual’s own pace. In certain contexts the course can be supported alongside some information sessions.

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What is it

IPT-Self Guided Learning is a booklet that can be given to patients and supported alongside 3 information sessions, but can also be supported through IPT-F, IPC and IPT-Group.  Self-help approaches are being used increasingly in healthcare settings and are endorsed by the recommendation of the NICE guidelines for depression Innovative approaches involving booklet or internet approaches have been shown to reduce depression.

Aim

  • To provide an easy to follow manual that can help reduce patient distress and improve interpersonal functioning.

  • To increase help seeking behaviours in those patients who find it difficult to engage in health care and community settings.

  • To increase access to a more localised interventions and options for the treatment of moderate depression within the community.

IPT-Gender

Exploring the possibility of delivering the WHO group for the transgender population with a view to developing a peer support model.

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What is it

In general the LGBTQ (Lesbian, Gay, Bisexual, Transgender and Questioning) population has been found to be more vulnerable to depression than the general population. There is therefore scope to introduce the aspects of the Prospect Model to better serve the transgender community.

How will it be done?

  • Interpersonal Psychotherapy-Learning (IPT-L): 3 hour learning on the interpersonal approach that is suited for ALL staff working within on the front line. The training will be adapted to include specific needs of this population.

  • IPT-Transgender: The development of an IPT Manual based on the 16 session time limited protocol developed by Klerman et al. (1984) to provide individual treatment for those suffering from severe depression. The IPT-Manual for Transgender will be based on the traditional IPT model, but it will include specific modifications around issues that may arise for this population including psycho education around diversity as well as sensitivity to semantics that may risk leaving an individual feeling stigmatised or further marginalised. This is important as micro aggressions can happen inadvertently from the most well-meaning therapist.

  • Interpersonal Counselling (IPC): Provide adapted training to include specific needs of this population to mental health nurses and other support staff working in the third sector that can deliver this brief 6 session model.

  • IPT-Group (WHO 2016): Provision of an IPT-Group within the LGBT Health and Well-Being service for clients experiencing moderate depression. This will be initially delivered by a Psychologist and Assistant Psychologist with a view to training up someone in the service.  The group interpersonal therapy (IPT) for depression (WHO, 2016) is a modified version of IPT for depression through an 8-session group. The model has been designed to be delivered by either specialised or non-specialised staff.   The manual provides full guidance on how to deliver IPT for a group and makes use of simple language to make it easy to follow.

IPT-Primary Care

Aims to improve access to a low intensity Interpersonal Psychotherapy approach for the treatment of common mental health presenting problems including anxiety and depression.

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What is it

IPT-Primary Care aims to improve access to a low intensity Interpersonal Psychotherapy approach for the treatment of common mental health presenting problems including anxiety and depression and achieve parity between mental and physical health.Clinical psychologists will work alongside GPs in order for patients in NHS Scotland to have mental and physical health problems managed in equal manner.

How will it be done?

  • Interpersonal Psychotherapy-Learning (IPT-L): 1-2 hour training on the basic elements of the interpersonal approach for ALL staff at the Practice (as described above).

  • IPT-GP: GPs at practice trained in a 10 minute consultation that is informed by IPT principles and uses attachment theory.

  • Clinical Psychologist IPT-Formulation. Clinical Psychologist delivers a 30 minute consultation informed by IPT and attachment principles, and a formulation is created. Follow up is offered if required/initiated by patient in the form of additional 10-20 minute sessions/telephone consultations.

  • Interpersonal Counselling (IPC): Identify staff members that can be trained in IPC that can deliver this brief 6 session model within the primary care service.   This could be support staff, link workers or mental health nurse.

  • IPT-Group (WHO, 2016): Provision of an IPT-Group within primary care for patients experiencing moderate depression. This will be initially delivered by a Psychologist and Assistant Psychologist. The group interpersonal therapy (IPT) for depression (WHO, 2016) is a modified version of IPT for depression through an 8-session group. The model has been designed to be delivered by either specialised or non-specialised staff.

  • IPT- Self Guided Learning A booklet will be developed that can be given to patients and supported alongside 3 information sessions, but can also be supported through IPT-F, IPC and IPT Group. The information sessions are designed to help support the Self-Guided learning booklet and enable individuals to learn basic IPT skills that help them carry out tasks in the booklet. The sessions will be 3 x 90 minutes and are presented as a low level intervention.

  • IPT-Peer Group A peer model will be introduced as part of a phased approach. This will enable primary care patients to have ongoing support within the service after they have had some form of IPT input through one of the above formats.

IPT Perinatal

Given the importance of attachment in early childhood, IPT is a model that can fit well with the perinatal service, providing IPT input to help support the varying needs of the service.

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What is it

IPT has been adapted and utilised for the reduction of depression in both pregnant and post-partum women. IPT has been found to be effective in the reduction of depressive symptoms in pregnancy, the prevention of depression post-partum in ‘at risk’ women and the reduction of depression in the postpartum period. The Prospect Model aim to increase the access to interventions using the adaptations below:

Target Audience

Staff who work regularly with pregnant and post-partum women who are experiencing distress and/or low mood. IPT-AC is for patients who are in acute crisis.

How will it be done?

  • IPT-L: 3 hour learning on the interpersonal approach that is suited for ALL staff working in the perinatal service. The training will cover the importance and impact of relationships in our lives.

  • IPT-PI: A 2 session model aimed at strengthening support for individuals at risk of developing post partum depression. This will be delivered in the community with one session antenatal and one postnatal.

  • IPC-Pregnancy: Provide training to community and mental health nurses within the service or other staff who will come into contact with women in both the antennal and postnatal stages and can deliver this 6 session brief model.

  • IPT-AC (Perinatal): IPT-AC is a perinatal specific adaptation of a brief version of IPT that is delivered over 4 sessions for those presenting with acute distress. The model is designed to be delivered as soon as possible after presentation and is more intense that other interventions, with the 4 sessions taking place between 2-4 weeks.

Further Contact Details:

Training Contact Details:

IPT-L or IPC
Suzy Cooke

suzy.cooke@nhslothian.scot.nhs.uk

Clinical Lead for The Prospect Model
Dr. Patricia Graham
Research Lead for The Prospect Model
Dr. Debra Bowyer
IPT-F or IPT-GP
Dr. Richard Cosway
IPT-Perinatal, IPT-Gender, IPT-Group
or IPT-Self Guided
Dr. Catherine McKinven
IPT-AC
Catherine Moar and Claire Bashford
Strategic Lead for The Prospect Model
Dr Linda Irvine-Fitzpatrick