Understanding how clients recently discharged from psychological therapy manage their mental health problems

Research has proved psychotherapy to be effective (Wampold, 2007) though longer term outcomes are less well investigated and relapse still occurs (Crown, 2002; Eaton et al, 2008). There has been little research into how mental health is managed once discharged from therapy, yet the importance of self-management has been highlighted by both professionals and service users (Barlow et al, 2002; Todd et al, 2012). This study focuses on individuals who found psychological therapy to be of benefit and aimed to explore their experiences of how they manage their mental health on a daily basis after discharge. Eight participants who had completed a minimum of six sessions of therapy within adult psychological therapy services and subjectively felt they had benefitted at the time of discharge were interviewed about their experiences. Using thematic analysis to analyse the data, five core themes were identified; ‘how therapy is helping me now’, ‘life changing’, ‘things that helped therapy to be successful’, ‘things outside therapy that are helping me now’ and ‘how therapy could be improved’. Participants maintained their mental health in similar ways irrespective of the initial presentation of symptoms, type of treatment received and the therapist they saw. Subthemes offer a deeper understanding of what people took from therapy and how the changes made are still being used to maintain mental health. Important factors included the acceptance of mental health difficulties, previous difficult life experiences, and the recognition that continued effort and distress in life are to be expected. Understanding and changing interpersonal relationships was also highlighted along with the importance of valuing yourself and not putting others’ needs before your own. Specific strategies were also commented upon including cognitive techniques as well as relaxation and mindfulness. Findings from the analysis are discussed in relation to the literature, along with the consideration of clinical implications and future research.