While exploring the range of interventions focusing on mental and emotional wellbeing during transitions into retirement and beyond as we set out in our blogpost of 27 October 2014, we identified various different modes of delivery. It is often hard to separate out content, approach and delivery, as they are all integral to an intervention. Many of the approaches used a digital platform, for example Living life to the Full and the Newcastle Live Well project. Our blog post on in January Digital Support for Emotional Wellbeing in Later Life? looked at evaluations of computerised CBT programmes such as the Beating the Blues programme with older people, and found that those who were confident with computers found it acceptable. However, although growing, there is still a relatively small percentage of people aged 65+ who are using the internet – see discussion here: Digital or Face-To-Face Therapeutic Work – What Works Best
Other interventions we explored used more traditional face to face group work, and indeed research reviews generally identify better outcomes from group interventions than one to one approaches. This is not as straight forward as it may seem and a lot of consideration goes into how these are established and developed. The Let’s talk project, Let’s Talk – Wellbeing Support for Older People in Gloucestershire, pay particular attention to the groups being sited in a community location where there is a cafe so participants can socialise around the sessions; and a key aspect of Beth Johnson’s Foundation Age Readiness Programme is to take the intervention where people are – and to access people in part of their daily lives. With Mind’s resilience programme and the Shaftesbury Partnership’s Retirement Transition Initiative group dynamics is a key part of the intervention rather than just an aspect of the delivery; for both the building of social ties and linkages is key within the group. Many interventions also offer a mixture of approaches – for example Living Life to the Full has a web-based life skills course but is also provided in one to one and group settings.
In our workshop bringing experts together, we identified some key elements to delivery of these interventions if they are to be successful:
- Marketing and branding of interventions is crucial to their success – if people do not recognise it as of use to themselves they will not engage with it, nor are others likely to refer them to it;
- Flexibility is key, and offering a menu of different approaches for different individuals or groups of people – through groups, one to one, on line, in self help books as part of another programme.
- It is important to understand the variety and relevance of delivery methods and what works best for different people
- It is important to be flexible about content structure, location, duration and timing and be able to reflect and change this during the intervention when necessary.
- There is a need to de-professionalise and de-jargonise “life skills” and make sure people know how and where to access information and support.
- The broader context of people’s lives need to be taken into account and think about infrastructure and other barriers
- An intervention should be kept simple, sustainable and credible so that it can become business as usual with no extra investment of staff at a local level
Over the last blogs, we have identified many different players and organisations working in this area to deliver such interventions, ranging from local government, National Government and the NHS, voluntary sector, private sector, employers and housing associations.
One of the key things to bear in mind for the development of interventions is indeed how to deliver and engage with the people who will benefit from them, recognising that people in later life are far from one homogenous group (see for example our discussion of What are the predictors of poor retirement transitions, and the blogs we wrote about the experiences of LGBT and members of BME communities in later life), and to be able to be flexible and creative enough to reach them. This is true too, to some degree, of our premise that the content of an intervention (to build mental resilience) should also be mixed including elements of mindfulness, positive psychology, CBT, etc. (see our discussion in So what have we learned – part 5)
As our blog about Future Roots Delivering Services in Rural Areas identified with their outreach programme for rural men
“I think the lessons from this is that supporting wellbeing in later life can be achieved in different, and sometimes novel, ways. We have found that by identifying specific groups with unmet needs it is possible to develop a solution tailored to them”