Enhancing primary care psychological therapy for clients with comorbid physical health conditions: A Critical Discourse Analysis investigation into interprofessional identity

Abstract

Background / Aim: Improving Access to Psychological Therapies (IAPT) services are the largest provider in England of primary care psychological therapy for depression and anxiety disorders. Over recent years there has been increased recognition of the importance of therapists and their physical health colleagues (e.g. nurses, physiotherapists or other allied health professionals) integrating care for patients with comorbid long-term health conditions and common psychological disorders. Specialist teams have been creating differentiating Psychological Therapists as Core and Integrated. The aim is to investigate the implications of this shift for Therapists’ professional identity. Method: A Critical Discourse Analysis was conducted based on five focus groups with eighteen professionals from Core IAPT, Integrated IAPT and physical healthcare backgrounds. Key Findings: Discourses related to expertise, responsibility and innovation / creativity emerged from the corpora. The research highlights the niche set of behaviours, skills, values and attitudes under construction by Integrated Therapists and the way in which their role shapes and is shaped by their interactions with their counterparts. Implications: The research makes recommendations for Integrated Therapists’ professional identity including to showcase niche skills and effective collaborative therapy. Future research recommendations are made regarding unheard voices and silenced discourses in professional identity reconstruction. Key Terms: Professional Identity; Integrated Therapy; Cognitive Behaviour Therapy; Long-Term Conditions and Medically Unexplained Symptoms (LTC/MUS)