"I know there's a net there" : experiences of Focused Acceptance and Commitment Therapy (fACT) intervention : a new approach to psychological support in primary care : a thesis presented in partial fulfilment of the requirements for the degree of Master of Arts in Psychology at Massey University, Palmerston North, New Zealand

Abstract

Psychological distress occurs at an increasing rate within society, with research into the levels of care showing a disturbing gap, especially in the “missing middle”. There has been a growing trend to increase access to mental health services by developing integrated care models within primary healthcare organisations in New Zealand in an attempt to deal with distress in earlier stages. Through semi-structured interviews, this research gained insight to the experiences of patients who participated in a fACT therapy service offered at a primary healthcare organisation in Palmerston North, New Zealand. Participants responses were transcribed and themes identified. By focusing on patients’ perceptions of value, and how they made sense of accessing psychological support services within primary care, three main themes emerged from the findings: expectations of care, stigma and processes. Findings showed that patients could be split into two different groups. The first, those with mild to moderate psychological distress, reported positive experiences including a reduction of stigma, increased access to services and an alignment with their holistic model of care. The second group, typified by those experiencing severe or chronic distress, were also positive in regards to the concept of the service, but were found to more often report negative experiences due to expectations, and value of care. Overall, patients who engaged in the fACT service were supportive of the ability to access mental health services directly from within their GP clinic. Their experiences led them to form strong opinions about the future of the service and its availability to others who are in distress. Issues around processes, such as consistency of care and time delays, and the effect this had on patients’ experiences, were also discussed in the findings. Recommendations for areas of future research were also discussed.