Multiple obstacles to psychological care from the viewpoint of addiction service users

Abstract

Purpose – The purpose of this paper is to explore addiction service users’ experiences of psychological interventions for depression symptoms, with an emphasis on understanding obstacles to engage with treatment. Design/methodology/approach – This was a thematic analysis of semi-structured interviews with ten people who took part in a randomised controlled trial of cognitive and behavioural interventions; four of whom never engaged with treatment. Findings – Five prominent obstacles to access therapy were: memory deficits, becoming overwhelmed by multiple demands and appointments, being housebound due to fluctuations in mental health problems, tendency to avoid the unfamiliar, and contextual life problems related to deprivation and social conflict. Research limitations/implications – The authors note some possible limitations related to overreliance on telephone interviews and interviewers’ field notes. The authors discuss the findings in light of epidemiological research, cognitive, behavioural and motivational enhancement theories. Practical implications – The authors propose it is important to recognise and address multiple obstacles to therapy. Offering therapy appointments that are co-located within addiction services and time-contingent to other social/medical interventions may help to address some of these obstacles. Originality/value – The present qualitative results complement the prior experimental research and enrich the understanding of how to maximise engagement with psychological interventions.