NewAccess in PHNs: Critical success features
Local implementation of NewAccess: Critical risks and success factors
To implement coaching models like NewAccess, it is critical that fidelity to the evidence-based Low intensity Cognitive Behavioural Therapy (LiCBT) model is maintained, and ‘therapeutic drift’ is avoided. Therapeutic drift is when a coach strays from the treatment model resulting in a modified course of intervention.
There are two main reasons to avoid this:
- In the UK’s Improving Access to Psychological Therapies (IAPT) program it has been demonstrated that strict adherence by coaches to the model leads to better outcomes for clients. Conversely, recovery rates start to diminish if the treatment recommendations are not adhered to. Participants in the IAPT program were found to be 1.5 times more likely to recover if they receive National Institute for Health and Care Excellence (NICE) compliant treatment, compared to those that receive care that is outside the NICE recommendations.1
- Delivering LiCBT within the prescribed evidence-based interventions protects both coaches and clients.
beyondblue has managed and maintained quality, safety and fidelity to the NewAccess program through:
- prescribing suitability criteria for the recruitment of coaches
- providing coaches with high quality, competency-based training
- clearly defining the LiCBT interventions within scope of NewAccess, and those which are out of scope
- actively and regularly supervising coaches, and ensuring that coaches restrict their role to the NewAccess LiCBT interventions
- clinical supervisors monitoring client outcomes and risks
- having clear systems and processes to ‘step up’ clients who require more intensive, clinical mental health services, and ‘step down’ clients to informal community care as appropriate.
- Utilising a client information management system which enables detailed, real-time reporting and automatic alerts for specific client issues or events that need immediate review.
While fidelity to the model is essential, it is equally important to maintain flexibility within coaching models – that is, allowing coaches to flex within the parameters of LiCBT to suit individual client needs, taking into account the diversity of the client experience and requirements.
Implementing coaching models
When implementing coaching models, it is important to remember that:
- services are embedded within the stepped-care model, including both health and social care systems
- services are located in accessible venues (or via phone/telehealth)
- people can self-refer to services and there is low stigma associated with the services
- the services are well known and accepted by both the general public and health professionals
- the workforce delivering coaching services are well-trained
- there are strong safety and quality assurance and monitoring processes, to ensure that commissioned coaching and/or e-mental health services are evidence-based, implemented as intended, and include clinical risk management systems.
- There is an ongoing focus on evaluation and monitoring, through regular analysis of clinical outcomes.
To speak to beyondblue about NewAccess in more detail, please email NewAccess
1. Gyani, A., Shafran, R., Layard, R. & Clark, D.M. (2013). Enhancing recovery rates: Lessons from year one of IAPT. Behaviour research and therapy, 51, 597 – 606.