Inpatient Distress Tolerance Group Intervention Pilot
Research type
Research Study
Full title
A transdiagnostic group intervention to enhance distress tolerance: A mixed methods pilot evaluation in an acute inpatient setting.
IRAS ID
251845
Contact name
Emma Boyd
Contact email
Clinicaltrials.gov Identifier
Duration of Study in the UK
0 years, 10 months, 28 days
Research summary
Summary Of Research
Research suggests that a low capacity to tolerate distress is a common underlying factor in the development and maintenance of a range of mental health problems. This study aims to pilot a mindfulness-based distress tolerance (DT) group intervention in an acute inpatient setting to assess the acceptability and feasibility of the intervention for both staff facilitating and patients receiving the intervention. The study also aims to explore if the proposed intervention can help improve DT through developing mindful acceptance of emotions.The study will be open to patients having difficulty with DT, regardless of their diagnosis. Participants will be recruited from two inpatient wards via referral from ward staff. Once they have provided informed consent, they will be asked to complete a battery of questionnaires including: demographic information; self-report measures of acceptance, coping, DT, and general distress; and a mirror tracing task to measure behavioural DT capacity. Participants will also be asked for their consent to obtain information from clinical notes (including electronic records). This will include demographic information and information about their daily use of medication as required, which will be used as a measure of coping. Participants then enter a 7-day baseline period where they will complete the outlined questionnaires daily prior to entering the DT group intervention which will be open and rolling and take place in the ward. Each particpant can attend twice a week for 1.5hrs for up to three weeks. The group will be facilitated by the researcher and trained ward staff. Throughout this period, participants will be asked to complete a shorter battery of questionnaires daily. Upon completion, participants and members of staff will be interviewed by the researcher on their experiences of the intervention and participants will complete the final battery of measures and mirror tracing task.
Summary Of Results
Background: Due to limited psychology resources in acute inpatient settings, and indirect work with teams and the wider system being a large part of this role, it is important that patients in acute inpatient settings have access to psychological interventions and that interventions cater to the diverse mental health needs of this population. Group-based interventions have been found to be an effective way of meeting this demand in inpatient settings. Distress tolerance (DT) has been found to be a common underlying factor in the development and maintenance of a wide range of mental health problems. However, there are no published studies exploring the feasibility and acceptability of an adapted DT group intervention in this setting to date.Aims and method: This study aimed to evaluate whether an 6 session adapted DT group intervention in an acute mental health inpatient setting would be feasible and acceptable. The group was piloted over a four- month period, during which time, 19 participants were enrolled in the study. The group was open and rolling, with two 1.5hr sessions delivered per week. Participants completed measures of DT, acceptance, psychological distress, and coping pre and post-intervention. They also completed daily measures of DT, acceptance, and psychological distress over a seven day baseline phase and for the duration of their participation in the study. Feasibility and acceptability were assessed through session attendance, study drop-out rates, coping skills use pre and post intervention, and interviews with participants and staff members.
Main findings: The results from the study suggest that a DT group intervention in an acute inpatient setting is feasible and acceptable. Feasibility and acceptability was evidenced through high recruitment rates, treatment uptake, attendance, and low session drop-out rates. Findings from staff and patient interviews demonstrated that the group intervention was valued by participants and staff alike. However, mindfulness practices were associated with negative acceptability for some participants. This should be considered further when developing future group interventions in acute inpatient settings. Findings also indicated that the intervention may have contributed to improvements in DT, psychological distress, and enhanced coping skills use post-intervention. Future studies assessing the effectiveness of this intervention would be advantageous.REC name
West of Scotland REC 3
REC reference
18/WS/0207
Date of REC Opinion
10 Jan 2019
REC opinion
Further Information Favourable Opinion