Can it work? Barriers to delivering Problem-Solving Treatment in a low vision rehabilitation setting

Abstract

Background: Limited service uptake and availibility frequently prevent the management of depression in vision impaired adults. The aim of this study was to identify barriers and enablers to the implementation of Problem-Solving Treatment (PST) in a national low vision rehabilitation setting, when delivered by rehabilitation staff over the telephone. Methods: Twenty-two staff completed a semi-structured interview. Barriers and enablers were identified using inductive thematic analysis and were mapped to predefined themes. Themes were grouped under four key domains: individual (professional); individual (client); intervention; and environment/organisation factors. Findings: Frequently reported barriers were a lack of role recognition (professional), poor understanding of PST (client), no face-to-face contact (intervention) and limited organisational awareness of PST (environment/organisation). Enablers included finding PST rewarding (professional), recognising benefits early in the treatment (client), a practical focus (intervention) and comprehensive PST staff training (environment/organisation). Discussion: Offering PST in low vision services may be feasible with sufficient resources to ensure staff delivery is fully-supported, PST is effectively communicated and promoted and flexibility is offered around the mode of delivery.