Compassionate Care in Improving Access to Psychological Therapies Services: A Grounded Theory Approach

Compassion has inspired interest across the centuries, attracting definitions from different disciplines and, more recently, leading to the development of theoretical models of understanding and therapeutic modalities. Aspects of the NHS constitution include compassion as one of the six Cs outlined as core values: care, compassion, competence, communication, courage and commitment (Department of Health, 2015). Similarly, the Improving Access to Psychological Therapies (IAPT) manual (2018) incorporates compassionate care. IAPT is one of the main providers of primary mental health care in the NHS UK, and although compassion has been prioritised by the IAPT agenda it has not been investigated within these services.

The current study addresses the question “What is the process of compassionate care in IAPT services?” It also aims to generate knowledge about the facilitators and inhibitors of compassionate care in IAPT. Semistructured interviews were conducted with 12 qualified clinicians. This study adopted a critical realist position, which informed the Grounded Theory methodology.

A new conceptual model was generated: Enacting Compassionate Care in IAPT Services. The five corresponding categories are Possessing Core Attributes and Skills of Compassion, Building an Interpersonal Connection, Meaningful Response to Suffering, Conditions Nurturing Compassionate Care and Conditions Hindering Compassionate Care. The main findings propose that enacting compassionate care is a dynamic process encompassing aspects that are individual, relational and behavioural. It involves clinicians employing core attributes and skills, to build a connection with patients and to respond to their suffering in a meaningful way. The findings have also highlighted the importance of reviewing service procedures, as well as the structural and emotional resources made available to nurture compassionate care. The limitations of this study and recommendations for future research are discussed.