Enhancing member engagement in a Tier 3 personality disorder service during COVID-19: evaluation of a virtual group programme. Issue 6 (9th November 2022)

• Record Type: Journal Article
• Authors: Smith, Emma; Papastavrou Brooks, Cat; Clifford, Emma; Giles, Emily; Dring, Jessica; Startup, Helen
• Is Part Of: Behavioural and cognitive psychotherapy. Volume 50:Issue 6(2022)
• Page Start: 629
• Page End: 643
• Publication Date: 2022-11-09
• Subjects: attendance -- COVID-19 -- engagement -- group therapy -- online therapy -- personality disorder -- virtual working; Behavior therapy -- Periodicals; 616.89142
• DOI: 10.1017/S1352465822000339
• Languages: English
• ISSNs: 1352-4658

Abstract

Abstract: Background: Drop-out rates from evidence-based interventions for people with a diagnosis of personality disorder (PD) are high. The COVID-19 pandemic has likely exacerbated barriers to engagement with the introduction of virtual working. Virtual therapy has a good evidence-base for Axis I disorders, but limited research for Axis II disorders. Aims: To investigate facilitators and barriers to engagement in a Tier 3 PD service virtual group programme. Method: A virtual group programme was developed in collaboration with service members, and analysed members' attendance rates over a 5-month period pre- and post-COVID-19. Thematic analysis of semi-structured telephone interviews with 38 members is reported, describing their experience of the virtual group programme. Results: Attendance rates were significantly higher pre-COVID (72%) than post-COVID (50%). Thematic analysis highlighted key barriers to attendance were: practical issues, low motivation, challenges of working in a group online and feeling triggered at home. Main promoters of engagement were: feeling valued, continued sense of connection and maintaining focus on recovery. Discussion: The results suggest that the pandemic has exacerbated relational and practical barriers to engagement in a Tier 3 PD service. Ways of enhancing engagement are discussed, as well as preliminary recommendation for services offering virtual therapy to people with a diagnosis of PD.