Evaluating response to a brief distress tolerance intervention delivered in an adult secondary care community mental health service

Abstract Brief distress tolerance interventions aimed at improving ability to tolerate psychological discomfort are being used trans-diagnostically, by both clinicians and paraprofessionals. Such brief interventions, delivered by a range of professionals could help to bridge the current worldwide gap between demand for and availability of mental health support. Despite a good theoretical rationale for the effectiveness of distress tolerance skills, empirical evidence for stand-alone interventions is lacking. This report details an evaluation of a 6- to 8-week distress tolerance intervention delivered in a community mental health setting by clinicians and paraprofessionals, using routinely collected outcome data. The aim was to better understand data completion, the proportion of responders and any pre-intervention differences between responders and non-responders. Pre-intervention routine outcome measures were found to be reasonably complete, with good post-intervention follow-up. Distress tolerance specific measures were less complete. Where it was possible to calculate reliable change ( n =163), 58.3% of clients were classified as responders to the distress tolerance intervention which is comparable to CBT outcomes, and response rate is improving over time. There was no evidence that clients were more or less likely to respond depending on their age, presenting problem, mood scores pre-intervention, referrer discipline or the role of the person delivering the intervention. Responders were found to have significantly poorer ability to tolerate distress pre-intervention compared with non-responders. Men were disproportionately likely to be non-responders which may indicate a need for improved access. Key learning aims (1) To increase practitioners’ understanding of distress intolerance as a factor that may sustain difficulties and serve as a valuable focus for intervention. (2) To demonstrate the potential effectiveness of a brief psychological approach delivered by clinicians and paraprofessionals targeting distress tolerance in achieving meaningful, reliable change. (3) To illustrate how services might identify which clients benefit most from a distress tolerance intervention to inform referral decisions and enhance client outcomes.