Overview of this resource
How ‘The Matrix’ can support delivery of evidence based psychological services in Scotland
The Matrix: A Guide for Delivering Evidence based Psychological Services in Scotland, which will be referred to as ‘The Matrix’, was initially developed in 2011 and substantially updated in 2014/15 prior to this revision in 2022. Stakeholders consistently report the document to be an invaluable and widely used tool in the development and maintenance of high quality, safe and effective psychological therapies and interventions in Scottish Services. This update recognises changes in the policy and delivery landscape including national policy such as health and social care integration, changes in service delivery, emerging clinical evidence and the impact of the recent COVID 19 pandemic.
Two important elements of the recent review include:
- Using implementation science methodologies to consider the efficacy literature in the context of wider factors that affect choice and service provision, such as treatment acceptability and resource/training implications.
- Reflecting the perspectives of people who use services.
Overview of this resource
The Matrix is designed to support evidence-based practice of the delivery of psychological therapies and interventions through 4 key elements:
This section provides an overview of the current delivery landscape including an update on policy and key contextual factors, updates reflecting the need to consider digital and technologically enabled delivery, the role of people who use services and definitions of the range of ways psychological practice can be delivered.
Publicly funded services/NHS and partnership services should provide interventions for which there is good evidence of effectiveness; and clearly, where an intervention has been proven ineffective or harmful, it should not be provided within the NHS. The tables provide an accessible overview of the current evidence base in relation to the psychological therapies and interventions which offer best outcomes for a range of presentations and difficulties.
Interventions included in the evidence tables are reviewed in detail to enable services to consider the ‘goodness of fit’ of the intervention for their context. This summary includes implementation factors such as fit with local needs and additional considerations such as requirements for local expertise to ensure governance.
This section summarises best practice with regards to governance structures and training pathways to support strategic service planning. It also outlines other important elements in facilitating effective implementation of psychological interventions and therapies, including data support systems and leadership.
Aim
This guidance document should support local planning for the delivery of high quality, person centred, safe and evidence based psychological therapies and interventions to sufficient scale in Scotland to meet the ambitions of timely access. This includes guidance on delivering services in line with key Scottish Government policy, including the NHS Healthcare Quality strategy (2020)[2] and providing a summary of the best available evidence base for both common mental health presentations and other areas where psychological expertise has an evidence of effectiveness.
This document is for guidance and does not replace any local policy or governance decision making as this remains the responsibility of the local Health Board. Integrated Joint Board, or other services provider. Scottish services have evolved to fit the needs of certain settings or populations in diverse ways and the guidance reflects some of the options available to represent informed choices in what psychological therapies and interventions to provide and the mechanisms by which they can be provided.
This guidance takes account of the COVID pandemic and the likely impact of this longer-term impact both on demand and on service delivery.
Because of the ongoing nature of evidence review, this evidence tables and intervention information will be iteratively updated following a standardised prioritisation approach which has been agreed with stakeholders including Heads of Psychology Scotland and Scottish Government Mental Health Division.