Can the theory of planned behaviour (TPB) predict trainee clinicians’ use of CBT self-help materials in step 2 mental health services?

Section A reviews and synthesizes the extant literature on adherence to clinical guidelines, with specific reference to the use of CBT self-help interventions as a mainstay within the IAPT programme. The review also evaluates the utility of one psychological framework, namely the theory of planned behaviour (TPB), in assessing the cognitive factors that may be most associated with compliance in this context. The review ends by suggesting an avenue for future research.
Section B In spite of evidence for their efficacy and effectiveness as well as the recommendations of NICE, CBT self-help materials are not used routinely or used as an intervention in their own right in mental health services.
Aims: This cross-sectional study set out to assess whether the main constructs of the TPB, namely, attitudes, subjective norms (SN) and perceived behavioural control (PBC), as well as past use, self-help training and demographic characteristics, could predict IAPT psychological well-being practitioners’ (PWPs) intention to use CBT self-help materials in their clinical practice.
Method: A convenience sample of PWPs (n=94) completed a web-based, mixed closed and open-response questionnaire, which was developed from an earlier elicitation study with a sub-sample of their colleagues. The data generated were analyzed by linear, multiple regression, mediation, and qualitative analyses.
Results: The TPB’s main constructs predicted PWPs’ intention to use self-help materials in their clinical work, with attitude being most significant. Past use of self-help materials emerged as both a direct predictor of intention, as well as indirectly related to intention, independent of the mediating effects of the main constructs. The overall extended TPB model explained a respectable 70% of the variance in intention. However, neither self-help training nor demographic factors were associated with PWPs’ intention.
Conclusion: It is recommended that future research could extend the methodology to prospective, longitudinal investigations of PWPs’ actual use of self-help materials. It is hoped that this would further elucidate the cognitive factors that are involved in PWPs’ decision-making when they are actually using the materials.
Section C sets out and answers four specific questions that guide a reflective critical appraisal of the processes involved in the execution of this research project.