Informal carers play an essential role supporting people with physical and mental health problems undertake activities of daily life, manage their conditions, provide emotional support, and are commonly responsible for steering the person they care for through complex health and social care systems. Estimates indicate that 34% of the adult population across Europe provide some form of informal care (Verbakel et al., 2017), with prevalence rates expected to increase given an ageing population alongside increased prevalence of long-term conditions. This is concerning given that carers often experience negative outcomes related to the caregiving role such as financial strain and poor physical and mental health (Coumoundouros et al., 2019; Kayaalp et al., 2021). Furthermore, rates of depression and anxiety amongst carers exceeds that of the general population resulting in significant personal and societal costs related to increased morbidity, lower productivity (Bauer et al., 2015; Wilson et al., 2007) and reduced quality of care provided by the person they care for (Smith et al., 2011). Promoting wellbeing and providing better support for informal carers has therefore been recognised as critical to the future of the NHS (Carers UK, 2014). This priority has been acknowledged by the NHS Five Year Forward View for Mental Health (Mental Health Taskforce, 2016) placing greater expectations on mental health services and staff to ensure accessible and acceptable evidence-based treatment for informal carers.
Enhancing competency of low and high-intensity CBT practitioners to work with informal carers, ensuring services can overcome the many barriers to accessing treatment and providing the workforce with clearer protocols is therefore of importance and informs the focus of this workshop.
Key learning objectives:
With respect to informal carers:
- Develop an understanding of mental health difficulties experienced and extent of the problem.
- Appreciate barriers experienced when trying to access treatment.
- Recognise difficulties faced when engaging informal carers in treatment and consider ways to address these.
- Appreciate ways behaviour change approaches can be used to enhance treatment engagement.
- Recognise a range of community and social organisations available to support wellbeing and offer practical support.
- Informed by research programmes, explore ways low-intensity CBT has been adapted to enhance acceptability and can be used to promote wellbeing.
Professor Paul Farrand is Professor of Evidence-Based Psychological Practice and Research. Paul is Director of the Low-Intensity CBT clinical training portfolio within CEDAR; Psychology, University of Exeter, published extensively in this area, developed written Low-Intensity CBT interventions commonly adopted by IAPT services and editor of Low-Intensity CBT Skills and Interventions: A Practitioners Manual (SAGE, 2020). Paul’s currently research focusses upon adapting Low-Intensity CBT to accommodate people with diversity including informal carers, Sunni Muslims in Saudi Arabia and England, Armed Forces Veterans, people with long term physical health conditions and is currently involved in work developing an assistant psychological practitioner role to work within medical specialties. He is an Advisory Board member for the Uppsala University (Sweden) Psychosocial Care Programme (U-CARE) and Associate Editor of the Cognitive Behaviour Therapist journal with responsibility for research in Low-Intensity CBT. Given a national and international reputation in Low-Intensity CBT, Paul is a member of the Expert Advisory Groups for the IAPT programme and Psychological Practice in Physical Healthcare.
Dr Joanne Woodford is a researcher in Healthcare Sciences and e-Health, focussing on informal caregiving and family mental health at the Department of Women’s and Children’s Health, Uppsala University, Sweden. She is an expert in the development and adaptation of written and internet-administered Low-Intensity CBT interventions for depression and anxiety. Joanne has developed a wide range of interventions for informal caregivers of people with stroke, dementia and parents of children with cancer. She is currently principal investigator for several research projects in this area, including developing psychological interventions for informal caregivers of people with cancer, chronic kidney conditions and adult-daughters providing informal care to their parents. Joanne is also a member of the ENTWINE consortium, a Marie Skłodowska-Curie Innovation Training Network, funded by the European Union. The consortium is designed to address a range of challenges experienced by informal caregivers and issues concerning the development and use of innovative psychological and technology-based interventions for the population. Joanne is currently supervising seven PhD students, leads on the delivery of PhD level training courses in Health Services research and worked on many educational programmes directed at training mental health professionals in Low-Intensity CBT.
Bauer, J.M. & Sousa-Poza, A. (2015). Impacts of informal caregiving on caregiver employment, health, and family. Journal of Population Ageing, 8: 113-145.
Carers UK (2014). Policy Briefing: NHS Five Year Forward View. Available online at: https://www.carersuk.org/for-professionals/policy/policy-library?task=download &file=policy_file&id=5048
Coumoundouros, C., Ould Brahim, L., Lambert, S.D. & McCusker, J. (2019). The direct and indirect financial costs of informal cancer care: a scoping review. Health and Social Care in the Community, 27: e622-636.
Kayaalp, A., Page, K.J. & Rospenda, K.M. (2021). Caregiver burden, work-family conflict, family-work conflict, and mental health of caregivers: A mediational longitudinal study. Work & Stress, 35: 217-240.
Maher, J. & Green, H. (2002). Carers 2000. HMSO: London.
Mental Health Taskforce (2016). Five year Forward View for Mental Health. Available online at: www.england.nhs.uk/mentalhealth/taskforce
Smith GR, Williamson GM, Miller LS, et al. (2011). Depression and quality of informal care: a longitudinal investigation of caregiving stressors. Psychology and Aging, 26: 584-591.
Stansfeld, S., Smuk, M., Onwumere, J., Clark, C., Pike, C., McManus, S., Harris, J. & Bebbington, P. (2014). Stressors and common mental disorder in informal carers–An analysis of the English Adult Psychiatric Morbidity Survey 2007. Social Science and Medicine, 120: 190-198.
Wilson, M.R., Van Houtven, C.H., Stearns, S.C., et al. (2007). Depression and missed work among informal caregivers of older individuals with dementia. Journal of Family and Economic Issues, 28: 684-698.
Verbakel, E., Tamlagsrønning, S., Winstone, L., Fjær, E.L. & Eikemo, T.A. (2017). Informal care in Europe: findings from the European Social Survey (2014) special module on the social determinants of health. European Journal of Public Health, 27(suppl_1): 90-95.