Strength and limitations
A strength of this study is that the findings are likely transferable to other primary care services, or similar services and populations, as the services involved in this study used nationally standardized treatments and service models, such as CBT, motivational interviewing and the NCSCT's standard treatment programme.Use of a critical realist perspective allowed us to focus on understanding, instead of describing, social reality. Mental health treatment happens within a social reality as people and their actions influence the treatment pathways, and each is made up of, and influenced by, people's actions.