3 - (OP23) Enhancing Sustained Recovery After Low Intensity CBT: Co Produced, Scalable Relapse Prevention Recommendations for Primary Care Mental Health Services

Background: Relapse following successful low intensity interventions in NHS Talking Therapies (TTad) for anxiety and/or depression remains common, and routine relapse prevention practices are inconsistently implemented. The aim of this NIHR RfPB-funded research programme (NIHR 204037) is to identify, through a multiple stakeholder consensus approach, key recommendations constituting feasible, scalable relapse prevention practice in primary care mental health (PCMH) services.

Methods: Evidence was synthesised from three published studies: (1) a scoping review of relapse prevention approaches following guided self help; (2) a qualitative study exploring what supports ongoing recovery after low intensity treatment (23 patients; 25 providers and national leads); and (3) a multiphase participatory and consensus building study prioritising stakeholder endorsed recommendations.

Results: Thirteen recommendations emerged across individual strategies, community and third sector partnerships, workforce development, and service level improvements. These map onto 3 components: (i) core clinical maintenance practices expected in routine care but delivered variably (from no relapse prevention discussion to personalised plans and general signposting); (ii) personal recovery support, including autonomy supportive planning, values aligned goals and context sensitive coping beyond symptom management; and (iii) supporting transition to everyday life, including social network planning, links to community and digital wellbeing resources, and culturally and socially appropriate targeted signposting for under represented groups.
Patient and Public Involvement: PPI shaped this research programme from inception. Our PPI Co Applicant and 8 service users contributed to study design, workshops, recruitment, accessible materials, and ensuring lived experience informed decision making. Recent University of Liverpool funding supports a working group to co-refine intervention materials operationalising the 13 recommendations ahead of feasibility testing.
Conclusions and Implications: This programme identifies feasible ways to enhance long-term outcomes following CBT-informed low intensity treatment and presents the first integrated, stakeholder endorsed framework specifying relapse prevention practices. The recommendations offer a scalable, workforce aligned solution with potential to reduce unwarranted variation, address equity gaps, and align with the NHS Change Model’s “Three Big Shifts”. The work directly supports the WCCBT mission to promote high quality, evidence based psychological care and improve global mental health. The practical strategies are internationally relevant, offering transferable guidance for strengthening recovery, autonomy, and long-term wellbeing.