How nurses and other healthcare professionals training in cognitive behavioural therapy experience the challenge of applying new learning in their clinical practice: a grounded theory study

In this qualitative study, three cohorts comprising mainly registered mental nurses and one of graduate occupational therapists were interviewed concerning their experiences of attempting to apply recently delivered cognitive behavioural therapy (CBT) training in their routine clinical practice. Additionally, four respondents from nursing, medical, clinical psychology and occupational therapy backgrounds undertaking an award-bearing diploma level course in CBT were interviewed for the purpose of enhancing the depth and completeness of the study.<br/><br/>The training consisted of four series of six half-day workshops covering the basics of the theory and application of CBT. The research participants, who comprised the subset of the total from the cohorts sampled for the research, plus the additional four respondents, worked in a variety of mainly mental health hospital, in-patient, community and day clinic settings.<br/><br/>The main aim of the study was to gain understanding of how the research participants experienced the challenge of applying the training to their clinical practice.<br/><br/>The interviews were audiotaped then transcribed providing a basis for a grounded theory analysis of the research data. The analysis was cumulative in that the findings from the analysis of each new cohort was integrated into that from the previous findings. The findings from the occupational therapist cohort were analysed separately. Five main categories were identified: the core category of ‘<i>on the threshold'</i> along with other four other categories: ‘<i>negative thinking</i>’, ‘<i>overcoming difficulties</i> ‘<i>identity and relevance issues</i>’, and finally, ‘<i>understanding and cognitive change</i>’.<br/><br/>The results of the study confirmed findings from the existing literature that external, environmental deficiencies in the workplace could act as a barrier to training transfer. The results also however offered fresh insight into how internal, cognitive factors with their origins in role identity dissonance could equally act as a barrier to training transfer.<br/><br/>There was also evidence that some research participants were able to devise and utilize implicit strategies to overcome such barriers. These internal barriers to training transfer, their cognitive origins and behavioural consequences along with a description of the strategies some participants used to overcome them, were conceptualised using a cognitive-behavioural framework.<br/><br/>The study concludes by suggesting that there are grounds to believe that these findings might be used to illuminate and address internal barriers to the transfer of training during, and as part of a self-reflective component of future training interventions, facilitating the application of the teaching to the clinical domain.

Name dc:type.qualificationname

PhD

Level dc:type.qualificationlevel

Doctoral Thesis

Grantor dc:publisher.institution

University of Abertay Dundee

Year dc:date.issued

2007

Author dc:creator

• Martin, Stephen

Advisor dc:contributor.advisor

• McLeod, John

Language dc:language

eng

Identifier

oai:rke.abertay.ac.uk:studenttheses/1837ff86-9b84-44ef-9d96-f189124bd52e

OAI identifier oai:identifier

oai:rke.abertay.ac.uk:studenttheses/1837ff86-9b84-44ef-9d96-f189124bd52e