How to maintain recovery following low-intensity interventions for anxiety and/or depression? A qualitative exploration through perspectives of professionals and stakeholders

Background: Globally, 301 million people have anxiety disorders and 280 million have depression. Talking therapies are the preferred option against pharmacological treatment for these populations. In the UK, over half of those who received low-intensity evidence-based talking therapy for anxiety and/or depression relapsed within a year. This study explored practitioners and stakeholders' perspectives on current practices routinely use to maintain recovery over time and identified opportunities to improve long-term treatment effectiveness in NHS Talking Therapies services.

Methods: This is a qualitative study using semi-structured interviews. Twenty-five participants were interviewed remotely. Data were analysed deductively using the Consolidated Framework for Implementation Research (CFIR) and inductively to allow emerging codes that did not map into the framework.

Results: Of the 36 CFIR domains, 27 were evidenced in the data, and 17 new constructs were developed. Data emphasised the absence of standardised approaches in addressing relapse prevention, limitations on available resources, the need for further training, the importance of defining recovery beyond clinical symptoms, and recommendations were identified to support recovery over time.

Limitations: The sample comprised primarily White British females, reflecting the current workforce. Those interested in participating may have resulted in social desirability biases. Furthermore, focussing on professional perspectives may not represent service user experiences.

Conclusions: All participants agreed on the importance of interventions targeting recovery over time and emphasised the need for effective training and resources to support professionals and patients in sustaining treatment gains over time. Cost-effective interventions targeting long-term recovery could prove fruitful to improve current provision.