Background:High numbers of people present with common mental health disorders and co-morbid personality disorder traits in primary care ‘Improving Access to Psychological Therapies’ (IAPT) services in England and they receive sub-optimal treatments. No previous studies have explored the treatment experiences or needs of this patient population in England.Aims:This qualitative study explored the treatment experiences of patients (n = 22) with common mental health difficulties and co-morbid personality disorder as indicated by a score of 3 or more on the ‘Standardised Assessment of Personality – Abbreviated Scale’ (SAPAS) in receipt of primary care-based IAPT treatment.Method:A qualitative health research approach was used. Qualitative individual face-to-face semi-structured interviews were conducted. All interviews were audio recorded, data were transcribed verbatim and analysed using a framework analysis approach.Results:Findings revealed a need to adapt away from prescriptive cognitive behavioural therapy (CBT) treatment models towards more flexible, personalised and individualised treatment with this patient group. Time to emotionally offload, build a therapeutic relationship and link past experiences to presenting problems were highlighted as important.Conclusions:For the first time, the needs and treatment experiences of this patient group have been explored. This paper provides a unique patient experience insight that should be considered when exploring new approaches to working with and developing effective interventions via a stepped care approach.

中文翻译：

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初级保健中的人格障碍合并症“提高心理治疗的可及性”（IAPT）服务：一项探索患者对治疗经验的看法的定性研究

背景：在英格兰的初级保健“提高心理治疗的可及性”(IAPT) 服务中，大量患有常见精神健康障碍和共病人格障碍特征的人接受了次优治疗。以前没有研究探讨过英格兰这一患者群体的治疗经验或需求。目的：本定性研究探讨了患者的治疗经验（n= 22）在接受基于初级保健的 IAPT 治疗时，在“人格标准化评估 - 缩写量表”（SAPAS）中得分 3 分或以上表示有常见的心理健康困难和共病人格障碍。方法：A使用了定性健康研究方法。进行了定性的个人面对面半结构化访谈。所有的采访都被录音，数据被逐字转录，并使用框架分析方法进行分析。结果：结果显示，需要从处方性认知行为疗法 (CBT) 治疗模型转向更灵活、个性化和个性化的治疗。时间来减轻情绪，建立治疗关系并将过去的经历与提出的问题联系起来是很重要的。结论：首次探讨了该患者群体的需求和治疗经验。本文提供了独特的患者体验见解，在探索通过阶梯式护理方法进行有效干预和开发有效干预措施的新方法时应予以考虑。