Development of a Money Advice Intervention Within IAPT

Study Overview
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Brief Summary
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This study is the second study of a larger project and will begin the process of testing and the development of an integrated intervention on a series of case studies. The combined intervention provides psychological therapy and debt advice in tandem. The treatment pathway is based on interviews and focus groups with service users and staff and the themes that emerged. It will be trialled in the NHS' Improving Access to Psychological Therapies (IAPT) service. Participants routinely accessing this service who have debt issues affecting their mental health will be asked if they'd like to also take up support for their money worries, which will be provided by Citizen's Advice (CA). Researchers will take exit interviews with both service users and staff at the end of the treatment to develop the protocol further. Researchers will also assess measures of mental health and wellbeing that are routinely taken by IAPT to review the intervention.

Official Title
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Development of a Money Advice Intervention Within IAPT: Service User Case-studies

Conditions
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Mental Health Issue, Anxiety, Depression

Intervention / Treatment
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* Behavioral: Psychological Therapy
* Behavioral: Debt Advice


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: IAPT clients referred for 'high-intensity' one-to-one treatment in the South London and Maudsley NHS Trust (SLaM) Have mental health problems and experience of money problems that are effecting these Can access technology Exclusion Criteria: Inability to give informed consent due to mental incapacity (as assessed by IAPT therapists) Participants whose care team specify concerns regarding taking part in the study.

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 65 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Intervention Model: Single Group Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Combined intervention<br>Participants accessing one-to-one psychological therapy from the IAPT service will be asked if they have any money worries affecting their mental health. Suitable participants will be offered one-to-one support from a money advisor, who they will access in tandem to their therapy. | Behavioral: Psychological Therapy<br>* Participants will be receiving their one-to-one psychological therapy from IAPT as usual. They typically receive between 6 and 12 sessions with a psychological practitioner.<br>Behavioral: Debt Advice<br>* Participants will receive one-to-one support from a Citizen's Advice (CA) money advisor for as long as needed to resolve any money worries currently affecting their mental health.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Reliable recovery - anxiety | Changes on the Generalized Anxiety Disorder - 7 (GAD-7), from above clinical cut off pre intervention (> 5) to below cut off post intervention (<5). The seven items on the scale ask participants to rate on a scale of 0 (not at all) to 3 (nearly everyday) how often they were bothered by each symptom. Total scores can range from 0 - 21, with higher scores indicating more anxiety. | 6-12 weeks | 
| Reliable recovery - depression | Patient Health Questionnaire - 9 (PHQ-9), from above clinical cut off pre intervention (> 5) to below cut off post intervention (<5). The nine items on the scale ask participants to rate on a scale of 0 (not at all) to 3 (nearly everyday) how often they were bothered by each symptom. Total scores can range from 0 - 27, with higher scores indicating more depressive symptoms. | 6-12 weeks | 
| Reliable recovery - adjustment | Work and Social Adjustment Scale - 5 (WSAS-5), from above clinical cut off pre intervention (> 10) to below cut off post intervention (<10). The five items on the scale ask participants to rate on a scale of 0 (not at all) to 8 (very severely) how much they feel they are impaired for each task. Total scores can range from 0 - 40, with higher scores indicating more impairment across work and social tasks. | 6 - 12 weeks | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Financial Outcomes and service satisfaction | This survey has been adapted for the purposes of this study. It uses questions taken from the audit measure of service satisfaction used by Citizen's Advice. Participants are asked to rate on a scale of 1 (not at all) to 5 (a great deal) how much they experienced six possible effects from the combined intervention. Scores range from 6 to 30, with higher scores indicating more positive outcomes in relation to personal finances from the intervention. | 6-12 weeks |