Title: Counselling People with Dementia: a feasibility study investigating the potential for accessible therapy delivered through a social enterprise model
Funder: Economic and Social Research Council

Abstract: Our ambition is to develop an effective, flexible prototype for providing counselling services that are accessible to PLwD, using a social enterprise model of implementation (see below) that offers the potential to greatly improve the mental health of many people. A Healthy Ageing Catalyst Award will enable the feasibility testing of this novel and exciting approach driven by our vision to implement a wide-ranging strategy for embedding dementia-friendly counselling within a diverse range of community service provisions. Such humanistic benefits can bring essential value for enhancing life quality for people with dementia and older people in general, and can carry profound social and economic impacts through, for example, reducing admissions to hospital and residential care. In addressing this problem, we reflect the Scottish Government's (2020) National Action Plan (referred to above). This identifies the critical need for therapeutic supports to improve older people's mental health and wellbeing and, in particular, people with dementia and their carers. This project builds directly on a Phase 1 study (funded by the Chief Scientist's Office, Scotland). The Phase 1 study has involved a systematic review of the literature and speaking to PLwD, carers and counsellors to hear their views on what they want and need from a community-based counselling service. The Catalyst Award will allow me to test the findings in practice, and complete the second part of our vision for a 3-Phase research programme investigating counselling for people with dementia (and carers). Working with our end users, academic and practice collaborators, we will focus on the process of counselling experience and deliver against six specific objectives: 1. Assess the feasibility of study design and delivery components through the risk appraisal and testing of ethical procedures, the training programme, recruitment and the counselling process. 2. Assess the appropriateness of the research design and methods from an ethical perspective, informed by people with dementia (and carers), to ensure that their needs are paramount. 3. Conduct market research to test the potential for the implementation of a social enterprise model to introduce accessible counselling services across a range of community settings in Phase 3. 4. Devise a counsellor training programme, tailored guidance and delivery mechanisms to enable a flexible, evidence-based training package for counselling across the different tiers. 5. Formulate a robust theoretical paradigm to underpin a future pilot project to further test the implementation process and assess outcomes of the tiered counselling programme. 6. Write a funding bid for a future confirmatory, multicentre pilot study that will closely examine participant experience of the model, and its effectiveness and viability in different community settings (Phase 3).

Lay abstract: Project Aim: We want to test an accessible, community-based, counselling model to help meet the emotional health and well-being needs of people living with dementia. The Problem There is a clear gap in counselling for people living with dementia and carers. The people I interviewed spoke about difficult emotional challenges linked to their experience of loss and concerns about the future. Currently, counselling interventions are poorly accessed by people living with dementia and under-researched. Most therapists have no training in this area and typically, those working in dementia services have no counselling skills. Despite support being a Human Right for people living with dementia, many health staff and therapists are not aware of the potential benefits of therapy. It is clear from my interviews that this is not true. The Vision I want to work with Zinc, people living with dementia, carers and counsellors to develop an accessible counselling model that can significantly improve the mental health of people with dementia and others. Firstly, we need to test the research methods. and then test the dementia-friendly counselling model. Success means: 1) People living with dementia, carers and counsellors are involved in the research process ensuring our ideas and methods are ethical, creative and fit for purpose. 2) Using the findings from testing the methods, counselling process, and potential investor feedback, we co-create a tiered counselling training and delivery package for use across different public services, the third sector, community groups and businesses. 3) Sale and delivery of the package enables accessible and tailored counselling opportunities, helping to tackle loneliness and stigma. 4) People living with dementia and carers can choose how and where they access therapeutic support.

Research activity codes: 7.1 INDIVIDUAL CARE NEEDS
Health categories: NEUROLOGICAL;MENTAL HEALTH