Set-up, conduct and report a reasearch study of your choice. The report should include: the rationale for the study, aims, hypotheses, methods, results (interpretation and conclusions) and discussion.

SUMMARY

In this study the intention was to investigate the idea that the popular attitude about mental health in general and psychotherapy in particular is a poor one. Whereas physical pain and damage is seen as acceptable and has resulted in a great deal of time and money spent on repairing such damage similar efforts aimed at mental pain and damage is both disregarded and ignored.

Given this belief the population studied was that of a group of people working in a community health care setting. This group was chosen both because the belief was held they would have a more positive attitude to psychotherapy than the general population. In the event a comparison between the general population and the staff in the health service was not possible. The focus of the research was then focused on exploring the views of staff in a community health setting.

Overall the results showed that there was a lack of clarity from respondents about the usefulness of psychotherapy. Whereas they agreed mostly that talking was effective, the need for a person with special skills was thought necessary “only sometimes” rather than more generally. There was a tendency to view drug therapy as less useful than psychotherapy this was more from a negative view of drugs rather than a positive view of psychotherapy.

The implications of this research are clear for the psychotherapeutic profession. The effectiveness of the psychotherapeutic process needs to be explained much more clearly than at present. However, it also seems that this group of people would be open to such information and would likely make positive choices in favour of psychotherapy if they had more detailed knowledge.

INTRODUCTION

When the activity of completing a research study was put forward there were many possible areas of study that were discussed. However, personal experience with clients was brought forward that highlighted negative views held about mental health and psychotherapy.

In his book Emotional Intelligence, Goleman (1), says that its has taken so long for his book because “…feeling in mental life has been surprisingly slighted by research over the years, leaving the emotions largely unexplored…”

He cites an American study(2) that ran from the 1970s to the mid 1980s. He claims that it shows children doing poorly in; withdrawing from society, an increase in anxiety and depression, problems with attention and thinking, an increase in delinquent and aggressive behaviour. In his 1998 British focused book Oliver James(3) states studies showing the growing level of depression and negative mental health states in the UK. Although he advises that people can be helped with a good therapist he also approves of “…the healthy British scepticism towards such things…”

If the studies in the above two books are correct or even believed to be correct then its odd that more money and resources are not focused on mental health problems and that people are not demanding such services in higher numbers than would seem to be the case. That demand appears to be muted and that the professional development of practitioners is not under Government control suggests that in the view of the general public mental health as regards psychotherapy is of little importance.

The next step was then to turn to research the views of the general public about psychotherapy. Despite hours on the Internet, requests to colleagues and a prolonged discussion with the Health Education Authority there appears to be little research to be found on the attitudes on the general public towards psychotherapy.

The aim of this study was to begin to elicit the views of a group of people in the community health sector to begin to reveal exactly what their views were about psychotherapy. A number of ways of framing the hypothesis were considered:

A null hypothesis would be:

There would be no difference between the views held by staff in a community health setting and those of the general population. {What views exactly ?}

A one-tailed hypothesis would be that:

Staff in the Community Health Service have a more positive views of psychotherapy than the general population.

Given that no existing data was available the research hypothesis arrived at stated that:

Staff in the Community Health Service have negative views of psychotherapy. {Define "negative views"}

METHOD

How would I repeat your sampling frame if I were to replicate your study ?}

The participants chosen were those working in a primary care centre which also housed an NHS community trust head office, a pharmacy and a complementary health clinic. The numbers in the building were thought to be large enough to give a useful result and yet a number that could easily be handled by the researcher. There were 46 people identified from the internal phone directory. Given this number a census was selected rather than selecting a sample population.

Given that the study was looking for attitudes to psychotherapy an anonymous self completion questionnaire was selected as the most effective design to engage as many people in as short a time as possible. Whereas individual interviews would be the ideal this would take up more time than was available for the collection of the data and its analysis.

The independent variable was the questions set by the researcher the only dependent variable was a free text area at the end of the questionnaire. {"dependent variable"=responses to the questionnaire}

Permission was sought from the non-medical partner of the primary care centre and a letter was then sent with a the questionnaire to all staff in the building. Participants were asked to respond within one week via the internal mail.

The letter and questionnaire are reproduced in Appendix A.

{How was it constructed ?
Why were these questions included ?
Positive items were ?}

RESULTS

Overall 46 questionnaires were dispatched and 18 (39.13%) were returned. There were 15 (83.33%) women and 3 (16.67%) men. The average age of respondents was 40.59 years of age. Ethnicity was not asked.

The following professions were provided by respondents:

{Meta model this paragraph}

Table one: A summary of the responses.

{Which are ? [the statements]; Are these totals ? Percentages ?; Commentary ! Interpretation.}

Table two: Detailed responses sorted into positive and negative groups.

{ Commentary ! Interpretation.}

Chart 1

Chart 2

Chart 3

Chart 4

There have been no statistical test carried out on these results for two main reasons. These are:

i. the numbers are too small to show any significance

ii. there are no comparisons to be made with other similar research.

The original hypothesis was that: Staff in the Community Health Service have negative perceptions of psychotherapy. These results show that the tendency is towards the *negative or at least positive but with reservations*. Therefore the hypothesis is supported. {Which one exactly}

DISCUSSION

The main reason for carrying out this study was to explore the views of a group of staff in a community health care setting. Given the research discussed by Goleman and James earlier it might be thought that the NHS would therefore spend a significant proportion of its time ensuring that its staff were well educated about the most effective treatments that surround mental health. This seems not to be the case. {How do you draw this conclusion from your data ?"}

Whereas staff were not out and out hostile to the idea of psychotherapy there is clearly a great deal of doubt about its efficacy. Overall, more respondents disagreed with the negative statements than agreed with the positive. This can be seen in Chart 1. {We can infer from this.......}

In this chart it can be seen that the tendency is towards the “Only sometimes” view. Although a number of people agree with the positive statements a majority of this group are less sure of the place of psychotherapy. This is shown further in the next chart.

Although a majority of respondents felt that talking about their upset will help they are less sure about the need to talk to a skilled therapist. Chart 2 shows this.

These results suggest that psychotherapy is only to be used for a few specific issues. Respondents agreed in the main that having someone to talk to about problems was useful and sometimes this person should be outside of their usual relationships. However, there is disagreement about the need to talk to a trained professional. The majority view is that only for some specific issues would a trained therapist be necessary.

There is also some confusion when the question about drugs versus psychotherapy is put as in Chart 3.

This chart shows that when it comes to the definitive choice between the use of drugs or psychotherapy people in this community health setting are more likely to want to use something other than drugs but they are not sure if psychotherapy is the best answer. They don’t agree that drugs or psychotherapy are better than each other but they do agree that is certain circumstances each will be effective.

Finally, there is good reason for hope contained in these responses. Chart four shows that respondents held a positive view about the power of thought. They held the view that if they knew how they though about events in their lives then they would be able to change how they felt about them. This view was confirmed by their disagreement to the statement that the past has happened and talking about it cannot make them feel any better. So there appears to be a general view that talking about issues and thus psychotherapy can* be of use. {*=sometimes)

In future the effectiveness of the psychotherapeutic process needs to be explained much more clearly than at present. However, it also seems that this group of people would be open to such information and would likely make positive choices in favour of psychotherapy if they had more detailed knowledge.

Clearly, there is still more analysis of these results to be done than time will allow. Further, the responses would be very useful tools to be used in in-depth interviews to find out more about the beliefs that people hold. Also this research could be carried out in other community health settings to see if this centre holds similar views to others.

More research needs to be done to follow-up the original purpose of this study which was to compare the beliefs of people in the NHS to those of the general population and it seems that there is scope for that research to be carried out.

CONCLUSION

The main finding from this all to brief study would seem to show that staff in the Community Health Service have mixed views on the value of psychotherapy. Whereas psychotherapy is not dismissed altogether they see it only of use in specific circumstances.

This would suggest that the psychotherapy profession needs to promote both the wider benefits and specific limitations of the service more assertively to ensure that people are better informed. It would seem from these results that a better informed population might make more use of psychotherapy and suggest it to others.

APPENDIX A

A little about you:

Your Age:

Your Job/Profession:

Any other comments:

References

1. Goleman, D. “Emotional Intelligence” Bloomsbury 1995
2. Achenbach T, Howell C. “Are America’s children’s problems getting worse ? A 13 –year comparison.” Journal of American Academy of Child and Adolescent Psychiatry (Nov 1989)
3. James O, “Britain on the Couch” Arrow 1998