ORCID Profile
0000-0001-7006-6361
Current Organisations
Université Claude Bernard Lyon 1
,
Hospices Civils de Lyon
,
The Alfred
,
Swinburne University of Technology
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Publisher: Frontiers Media SA
Date: 21-01-2022
DOI: 10.3389/FRVIR.2021.672556
Abstract: Mindfulness practice involves bringing one’s attention to the present moment and noticing events as they unfold with a non-judgmental attitude of acceptance. Although mindfulness has been shown to reduce stress and improve mental health, it can be challenging to learn mindfulness techniques. Recent years have seen an interest in using virtual reality (VR) to help people learn mindfulness by immersing users in virtual settings that support an external focus of attention and reduce everyday environmental distraction. However, the literature currently lacks an understanding of how VR should be designed to support mindfulness. In this paper we describe the iterative design and evaluation of Place , a VR app that supports mindfulness practice by situating the user in a virtual forest environment. We present findings from our design process in which prospective users trialled Place and provided feedback on the design in focus groups. Our findings draw attention to factors that influenced the user experience and acceptance of VR for mindfulness, and we describe how the design was altered to address these factors. We end by discussing key design choices that designers should consider when creating VR for mindfulness. Our contributions include insight into the importance of following an iterative design process when creating a VR mindfulness app, and a framework that can be used to inform the design of future VR apps for mindfulness practice.
Publisher: Oxford University Press (OUP)
Date: 22-08-2023
Abstract: Ecological momentary assessment (EMA) involves completing multiple surveys over time in daily life, capturing in-the-moment experiences in real-world contexts. EMA use in psychosis studies has surged over several decades. To critically examine EMA use in psychosis research and assist future researchers in designing new EMA studies, this systematic review aimed to summarize the methodological approaches used for positive symptoms in psychosis populations and evaluate feasibility with a focus on completion rates. A systematic review of PubMed, PsycINFO, MEDLINE, Web of Science, EBSCOhost, and Embase databases using search terms related to EMA and psychosis was conducted. Excluding duplicate s les, a meta-analysis was conducted of EMA survey completion rates and meta-regression to examine predictors of completion. Sixty-eight studies were included in the review. Characteristics and reporting of EMA methodologies were variable across studies. The meta-mean EMA survey completion computed from the 39 unique studies that reported a mean completion rate was 67.15% (95% CI = 62.3, 71.9), with an average of 86.25% of the s le meeting a one-third EMA completion criterion. No significant predictors of completion were found in the meta-regression. A variety of EMA items were used to measure psychotic experiences, of which few were validated. EMA methods have been widely applied in psychosis studies using a range of protocols. Completion rates are high, providing clear evidence of feasibility in psychosis populations. Recommendations for reporting in future studies are provided.
Publisher: SAGE Publications
Date: 22-03-2013
Publisher: Oxford University Press
Date: 2015
Publisher: Frontiers Media SA
Date: 27-03-2015
Publisher: Frontiers Media SA
Date: 2013
Publisher: Frontiers Media SA
Date: 26-06-2020
Publisher: Informa UK Limited
Date: 2009
Publisher: Elsevier BV
Date: 02-2019
DOI: 10.1016/J.CPR.2018.11.001
Abstract: Negative voice-content is the best sole predictor of whether the hearer of an auditory-verbal hallucination will experience distress/impairment necessitating contact with mental health services. Yet, what causes negative voice-content and how interventions may reduce it remains poorly understood. This paper offers definitions of negative voice content and considers what may cause negative voice-content. We propose a framework in which adverse life-events may underpin much negative voice-content, a relation which may be mediated by mechanisms including hypervigilance, reduced social rank, shame and self-blame, dissociation, and altered emotional processing. At a neurological level, we note how the involvement of the amygdala and right Broca's area could drive negative voice-content. We observe that negative interactions between hearers and their voices may further drive negative voice-content. Finally, we consider the role of culture in shaping negative voice-content. This framework is intended to deepen and extend cognitive models of voice-hearing and spur further development of psychological interventions for those distressed by such voices. We note that much of the relevant research in this area remains to be performed or replicated. We conclude that more attention needs to be paid to methods for reducing negative voice-content, and urge further research in this important area.
Publisher: Frontiers Media SA
Date: 02-08-2022
DOI: 10.3389/FPSYT.2022.959467
Abstract: In the last decades, third wave approaches in cognitive-behavioral therapies (CBT) have shown effectiveness in treating several mental disorders, including schizophrenia spectrum disorders (SSD). Three crucial processes associated with clinical changes in patients include mindfulness, psychological flexibility (PF) and self-compassion (SC). PF is generally assessed by cognitive fusion (CF), a negative formulated key process of PF. The current study encompasses a cross-sectional design to examine the interplay of mindfulness, CF, SC and symptom severity in SSD. It was hypothesized that mindfulness is negatively correlated with symptom severity, CF mediates the negative relation between mindfulness and symptom severity, and SC moderates the link between mindfulness and CF. In total, 79 persons with SSD were recruited at the Department of Psychiatry and Neurosciences at the Charité – Universitätsmedizin Berlin. Correlations, as well as moderated mediation analyses, were performed using the analysis modeling tool PROCESS with total symptom severity and negative symptom severity as outcome variables, measured by the Positive and Negative Syndrome Scale (PANSS) and the Self-Evaluation of Negative Symptoms Scale (SNS). Results show that the moderated mediation hypothesis was confirmed for negative symptom severity assessed by SNS, however, not for total symptom severity assessed by PANSS. In general, the association between mindfulness and CF was stronger for participants with higher SC scores in our data. Future studies should investigate the relationship between mindfulness, SC, and PF regarding symptom severity in SSD in longitudinal designs while considering the impact on different outcomes and differences regarding assessment tools.
Publisher: JMIR Publications Inc.
Date: 19-06-2020
DOI: 10.2196/16730
Abstract: Web-based interventions are increasingly being used for in iduals with serious mental illness, including psychosis, and preliminary evidence suggests clinical benefits. To achieve such benefits, in iduals must have some level of engagement with the intervention. Currently, little is known about what influences engagement with web-based interventions for in iduals with psychotic disorders. This study aimed to explore users' perspectives on what influenced engagement with a web-based intervention for psychosis. A qualitative design was employed using semistructured telephone interviews. Participants were 17 adults with psychosis who had participated in a trial examining engagement with a self-guided, web-based intervention promoting personal recovery and self-management of mental health. We identified 2 overarching themes: challenges to using the website and factors supporting persistence. Both of the main themes included several subthemes related to both user-related factors (eg, mental health, personal circumstances, approach to using the website) and users’ experience of the intervention (eg, having experienced similar content previously or finding the material confronting). In iduals with psychosis experienced several challenges to ongoing engagement with a web-based intervention. Adjunctive emails present an important design feature to maintain interest and motivation to engage with the intervention. However, fluctuations in mental health and psychosocial difficulties are a significant challenge. Design and implementation considerations include flexible interventions with tailoring opportunities to accommodate changeable circumstances and in idual preferences.
Publisher: Frontiers Media SA
Date: 07-08-2015
Publisher: Frontiers Media SA
Date: 2015
Publisher: Elsevier BV
Date: 02-2020
DOI: 10.1016/J.SCHRES.2019.10.026
Abstract: Voice-hearing experiences can be distressing and impairing, and existing psychological treatments show modest effectiveness. Ecological momentary assessment and intervention (EMA/I) are two promising approaches which may be used as digital tools to support and enhance existing psychological therapies. The aim of this study was to investigate the potential clinical utility of smartphone-based EMA/I in a blended, coping focused therapy for voice-hearing experiences. This pilot RCT focused on feasibility, acceptability and preliminary estimations of efficacy. Thirty-four participants with persisting and distressing voices were randomised to receive the four-session intervention along-side treatment-as-usual (TAU) or TAU-only. Findings supported the feasibility and acceptability of the approach, with good engagement and satisfaction rates, and clinical outcomes showed the intervention holds promise for improving coping, overall severity of voices and to some degree their negative impact. This is the first examination of the use of EMA/I in a blended therapy for psychotic experiences, with findings suggesting these technologies show promise as clinical tools.
Publisher: Oxford University Press (OUP)
Date: 16-06-2014
Publisher: Informa UK Limited
Date: 07-2019
DOI: 10.1111/CP.12202
Publisher: Elsevier BV
Date: 12-2018
DOI: 10.1016/J.PSYCHRES.2018.09.013
Abstract: Mindfulness-based interventions show promise in the treatment of psychotic symptoms. From a theoretical perspective, there may be several benefits of mindfulness for in iduals who experience hearing voices. Related cross-sectional findings suggest mindfulness may protect against distress, disruption, negative beliefs, dysfunctional relational style and responding, and mood symptoms for in iduals who hear voices. To extend on previous findings, this study aimed to identify whether mindful relating to voices predicted voice-related negative impacts (distress, disruption and resistance), when the influence of voice-topography and mood symptoms were controlled for. Overall, 62 participants with a psychotic disorder who had experienced hearing voices in the previous week were given the South ton Mindfulness of Voices Questionnaire, Psychotic Symptom Rating Scales, Beliefs About Voices Questionnaire, Beck Depression Inventory-II, and Beck Anxiety Inventory. As predicted, greater mindfulness of voices predicted less voice-related distress and lower resistance to voices. Regression analyses revealed that when associated voice topography and mood symptoms were controlled for, mindful relating to voices explained a significant proportion of variance in voice-related distress and resistance. Conversely, mindfulness of voices did not significantly predict voice-related disruption. In the context of existing literature, these findings suggest further mindfulness-based protocols for persistent voices should be developed and trialled.
Publisher: Oxford University Press (OUP)
Date: 04-2018
Publisher: JMIR Publications Inc.
Date: 11-12-2015
DOI: 10.2196/RESPROT.4783
Publisher: Springer Science and Business Media LLC
Date: 11-07-2014
Publisher: Elsevier BV
Date: 02-2012
DOI: 10.1016/J.BRAT.2011.11.007
Abstract: Command hallucinations represent a special problem for the clinical management of psychosis. While compliance with both non-harmful and harmful commands can be problematic, sometimes in the extreme, active efforts to resist commands may also contribute to their malignancy. Previous research suggests Cognitive Behaviour Therapy (CBT) to be a useful treatment for reducing compliance with harmful command hallucinations. The purpose of this trial was to evaluate whether CBT augmented with acceptance-based strategies from Acceptance and Commitment Therapy could more broadly reduce the negative impact of command hallucinations. Forty-three participants with problematic command hallucinations were randomized to receive 15 sessions of the intervention "TORCH" (Treatment of Resistant Command Hallucinations) or the control, Befriending, then followed up for 6 months. A sub-s le of 17 participants was randomized to a waitlist control before being allocated to TORCH or Befriending. Participants engaged equally well with both treatments. Despite TORCH participants subjectively reporting greater improvement in command hallucinations compared to Befriending participants, the study found no significant group differences in primary and secondary outcome measures based on blinded assessment data. Within-group analyses and comparisons between the combined treatments and waitlist suggested, however, that both treatments were beneficial with a differential pattern of outcomes observed across the two conditions.
Publisher: Elsevier BV
Date: 03-2020
Publisher: Springer Science and Business Media LLC
Date: 14-03-2019
DOI: 10.1007/S00127-019-01681-2
Abstract: Loneliness has been identified as a significant challenge for people with psychosis. Interventions targeting loneliness are lacking but adopting a positive psychology approach may reduce loneliness, promote well-being, and support meaningful social interactions. Together with youth mental health consumers, we developed a digital smartphone application (app) called +Connect, which delivers positive psychology content daily for 6 weeks. Twelve participants diagnosed with a psychotic disorder were recruited from early psychosis services. Loneliness was assessed pre-intervention, post-intervention, and 3-month post-intervention. Acceptability, feasibility, and usability were measured post-intervention, including a semi-structured interview on the user's experience of +Connect. We found evidence for the feasibility of +Connect. All but two participants completed the +Connect program, completing 95% (40.10 out of 42 days) of the program. Furthermore, 66.67% (8 out of the 12 participants) remained engaged with the program 3-months post-intervention. Our data indicates preliminary evidence that +Connect may reduce loneliness, with scores from pre-intervention (M = 50.00, SD = 8.47) to post-intervention (M = 48.10, SD = 10.38) and 3-months post-intervention (M = 42.89, SD = 7.04). We found that positive reinforcement of in-game rewards and evidence of positive mood changes added to the feasibility of the app. Regarding acceptability, while 10% (1/10 participants) reported not finding +Connect useful or enjoyable, 90% of participants agreed that +Connect helped them to increase their social confidence, enjoy life, look forward to being with other people, and feel more connected with others. Participant interviews supported these results, with participants highlighting the app's strengths in providing useful information, stimulating self-reflection, fostering positive affect, and encouraging transfer of skills into their social interactions. While preliminary findings indicated that +Connect yielded high levels of acceptability and feasibility, it is important to consider that we recruited a small and selected s le of lonely young people. Further iterations of this proof of concept app, which can incorporate participant feedback such preferences for increased personalisation, in-app feedback, and gamification, may allow an opportunity to test an improved version in the future.
Publisher: American Psychiatric Association Publishing
Date: 11-2017
DOI: 10.1176/APPI.PS.201600523
Abstract: Ecological momentary assessment (EMA) and ecological momentary intervention (EMI) are technologies used to track fluctuations in experiences and prompt behavioral responses within the context of a person's daily life. Most commonly delivered via smartphone, EMA and EMI have potential to provide simple, cost-effective, and user-led treatment for psychotic disorders. This systematic review aimed to synthesize current research exploring the feasibility, acceptability, and clinical outcomes of EMA and EMI in the treatment of psychotic disorders. A systematic search was conducted identifying studies published between 1980 and July 7, 2016, by searching PubMed, PsycINFO, PsycARTICLES, and the Cochrane Central Register of Controlled Trials with combinations of search terms related to mobile devices, EMA and EMI, and psychotic disorders. Of 1,623 studies identified, nine met inclusion criteria for the review. These studies found satisfactory feasibility and acceptability and preliminary evidence of improved clinical outcomes. The interventions, which had a broad array of features, targeted remote monitoring of illness and symptoms, and they also targeted illness self-management by using momentary reminders or instructions for behaviors, including medication adherence, management of symptoms and psychosocial impairments, daily living skills, and goal achievement. The findings of this review provide preliminary support for the clinical utility of EMA and EMI in the treatment of psychotic disorders. Future research should explore further applications of these technologies with larger s le sizes and controlled designs.
Publisher: Elsevier BV
Date: 09-2015
DOI: 10.1016/J.JAD.2015.05.040
Abstract: Auditory verbal hallucinations (AVHs) are not uncommon in bipolar disorder (BD) and major depressive disorder (MDD), but there has been scant research in the area. The current paper aims to draw together and provide a critical overview of existing studies of AVHs in BD and MDD. A systematic review was undertaken using the search terms 'hallucinations' or 'hearing voices' in conjunction with 'bipolar disorder', 'mania' or 'manic-depressive' or 'major depressive disorder' or 'depression' or 'affective disorder' or 'mood disorder'. After applying a pre-defined set of inclusion criteria, 14 eligible peer-reviewed publications were accepted for further analysis. Prevalence rates of AVHs in BD (11.3-62.8%) and MDD (5.4-40.6%) varied. When psychotic features were examined, persecutory and grandiose delusions were especially common in BD (though the latter did not necessarily occur in conjunction with AVHs). A single known neuroimaging study has suggested increased fronto-temporal connectivity relating to AVHs in BD. Methodological challenges relating to fluctuations in mood states and limited use of validated instruments, coupled with post-episode recall bias, pose as specific barriers to the collection of meaningful phenomenological information. AVHs remains a central but largely understudied symptom in BD and MDD. Future research examining its phenomenology and clinical/neural correlates could bring about positive clinical implications as well as adapted therapeutic applications.
Publisher: Elsevier
Date: 2020
Publisher: Elsevier BV
Date: 03-2019
Publisher: Elsevier BV
Date: 03-2017
DOI: 10.1016/J.CPR.2017.01.002
Abstract: Current adjunctive psychosocial interventions for bipolar disorder (BD) aim to impact illness course via information sharing/skill development. This focus on clinical outcomes contrasts with the emergent recovery paradigm, which prioritises adaptation to serious mental illness and movement towards personally meaningful goals. The aim of this review is to encourage innovation in the psychological management of BD by considering three recovery-oriented trends in the literature. First, the importance of quality of life as a target of recovery-oriented clinical work is considered. Second, the recent staging approach to BD is described, and we outline implications for psychosocial interventions tailored to stage. Finally, we review evidence suggesting that mindfulness-based psychosocial interventions have potential across early, middle and late stages of BD. It is concluded that the humanistic emphasis of the recovery paradigm provides a timely stimulus for development of a next generation of psychosocial treatments for people with BD.
Publisher: Guilford Publications
Date: 08-2022
DOI: 10.1521/PEDI.2022.36.4.413
Abstract: Hallucinations and delusions in borderline personality disorder (BPD) are understudied. The authors explore the phenomenology of multisensory hallucinations and delusions in in iduals with BPD and compare them to those in in iduals with schizophrenia spectrum disorders (SSD). Clinical psychopathology was also explored. Eighty-nine adults participated and were categorized into four groups: BPD with voices, BPD without voices, SSD with high BPD traits, and SSD with low BPD traits. Among in iduals with BPD, 81% reported visual and tactile hallucinations, 75% reported olfactory hallucinations, and 94% experienced delusions. When comparing BPD with and without voices, there were no significant differences in nonpsychotic psychopathology. Slight differences were found when hallucinations in BPD were compared with hallucinations in SSD, but overall the experiences were similar across diagnoses. The BPD group also reported significantly higher rates of paranoia/suspiciousness and delusions of guilt than the SSD group. Multisensory hallucinations and delusions occur in BPD and should be explored when treating people with BPD.
Publisher: JMIR Publications Inc.
Date: 18-03-2020
DOI: 10.2196/16106
Abstract: Regular mindfulness practice has been demonstrated to be beneficial for mental health, but mindfulness can be challenging to adopt, with environmental and personal distractors often cited as challenges. Virtual reality (VR) may address these challenges by providing an immersive environment for practicing mindfulness and by supporting the user to orient attention to the present moment within a tailored virtual setting. However, there is currently a limited understanding of the ways in which VR can support or hinder mindfulness practice. Such an understanding is required to design effective VR apps while ensuring that VR-supported mindfulness is acceptable to end users. This study aimed to explore how VR can support mindfulness practice and to understand user experience issues that may affect the acceptability and efficacy of VR mindfulness for users in the general population. A s le of 37 participants from the general population trialed a VR mindfulness app in a controlled laboratory setting. The VR app presented users with an omnidirectional video of a peaceful forest environment with a guided mindfulness voiceover that was delivered by a male narrator. Scores on the State Mindfulness Scale, Simulator Sickness Questionnaire, and single-item measures of positive and negative emotion and arousal were measured pre- and post-VR for all participants. Qualitative feedback was collected through interviews with a subset of 19 participants. The interviews sought to understand the user experience of mindfulness practice in VR. State mindfulness (P .001 Cohen d=1.80) and positive affect (P=.006 r=.45) significantly increased after using the VR mindfulness app. No notable changes in negative emotion, subjective arousal, or symptoms of simulator sickness were observed across the s le. Participants described the user experience as relaxing, calming, and peaceful. Participants suggested that the use of VR helped them to focus on the present moment by using visual and auditory elements of VR as attentional anchors. The sense of presence in the virtual environment (VE) was identified by participants as being helpful to practicing mindfulness. Interruptions to presence acted as distractors. Some uncomfortable experiences were discussed, primarily in relation to video fidelity and the weight of the VR headset, although these were infrequent and minor. This study suggests that an appropriately designed VR app can support mindfulness practice by enhancing state mindfulness and inducing positive affect. VR may help address the challenges of practicing mindfulness by creating a sense of presence in a tailored VE by allowing users to attend to visual and auditory anchors of their choice and by reducing the scope of the content in users’ mind-wandering. VR has the unique capability to combine guided mindfulness practice with tailored VEs that lend themselves to support in iduals to focus attention on the present moment.
Publisher: Cambridge University Press (CUP)
Date: 10-11-2011
DOI: 10.1017/S1352465810000548
Abstract: Background : Cognitive behavioural therapy has been established as an effective treatment for residual psychotic symptoms but a substantial proportion of people do not benefit from this treatment. There has been little direct study of predictors of outcome, particularly in treatment targeting auditory hallucinations. Method : The Psychotic Symptom Rating Scales (PSYRATS) and Positive and Negative Syndrome Scale (PANSS) were administered pre- and post-therapy to 33 people with schizophrenia-related disorders receiving CBT for auditory hallucinations in a specialist clinic. Outcome was compared with pre-therapy measures of insight, beliefs about the origin of hallucinations, negative symptoms and cognitive disorganization. Results : There were significant improvements post-treatment on the PSYRATS and PANSS Positive and General Scales. Improvement on the PSYRATS was associated with lower levels of negative symptoms, but was unrelated to overall insight, delusional conviction regarding the origins of hallucinations, or levels of cognitive disorganization. Conclusions : Lack of insight and presence of formal thought disorder do not preclude effective cognitive-behavioural treatment of auditory hallucinations. There is a need to further understand why negative symptoms may present a barrier to therapy.
Publisher: Oxford University Press (OUP)
Date: 04-2018
Publisher: SAGE Publications
Date: 27-06-2022
DOI: 10.1177/00207640211028604
Abstract: Self-efficacy – positive beliefs about one’s own competencies and mastery – is associated with better recovery outcomes for people using mental health services. To translate the Self-Efficacy for Personal Recovery Scale (SEPRS) into Arabic and evaluate the psychometric properties of the Arabic version. An established translation methodology was employed, involving back-translation, comparison, forward-translation, comparison, and piloting. The pre-final version of the Arabic translated scale was tested for clarity with young people with a primary diagnosis of mental health problem. The final Arabic version and standardized measures of hope and loneliness were administered to 119 young people in two rounds. Internal consistency was adequate (Cronbach’s alpha = 0.87 in round 1, 0.91 in round 2). Consistent with the English version, a one-factor solution best fitted the data. The correlation between SEPRS and hope was R = 0.60 (round 1) and R = 0.61 (round 2), indicating convergent validity. The correlation between SEPRS and loneliness was R = −0.52 (round 1) and R = −0.60 (round 2). Correlation between test and retest was R = −0.998 indicated adequate test-retest reliability. Minimal floor and ceiling effects were detected. The use of the Arabic SEPRS with Arabic-speaking s les is supported. Further research to investigate ergent validity is warranted.
Publisher: Informa UK Limited
Date: 18-10-2013
Publisher: Oxford University Press (OUP)
Date: 2019
Publisher: Elsevier BV
Date: 12-2018
Publisher: Frontiers Media SA
Date: 14-08-2015
Publisher: Elsevier BV
Date: 04-2014
DOI: 10.1016/J.COMPPSYCH.2013.10.016
Abstract: Speech disturbances in schizophrenia impact on the in idual's communicative ability. Although they are considered a core feature of schizophrenia, comparatively little work has been done to examine their impact on the life experiences of patients. This study aimed to examine the relationship between schizophrenia speech disturbances, including those traditionally known as formal thought disorder (TD), and quality of life (QoL). It assessed effects on functioning (objective QoL) and satisfaction (subjective QoL) concurrently, while controlling for the influence of neurocognition and depression. Fifty-four patients with schizophrenia/schizoaffective disorder were administered the MATRICS Consensus Cognitive Battery (MCCB), the PANSS, MADRS (with separate ratings for negative TD [verbal underproductivity] and positive TD [verbal disorganisation and pressured speech]) and Lehman's QOLI assessing both objective and subjective QoL. Ratings of positive and negative TD, depression, and general neurocognition were entered into hierarchical regressions to explore their relationship with both life functioning and satisfaction. Verbal underproductivity was a significant predictor of objective QoL, while pressured speech had a trend association with subjective QoL. This suggests a differential relationship between speech disturbances and QoL. Verbal underproductivity seems to affect daily functioning and relations with others, while pressured speech is predictive of satisfaction with life. The impact of verbal underproductivity on QoL suggests it to be an important target for rehabilitation in schizophrenia.
Publisher: Cambridge University Press (CUP)
Date: 09-11-2012
DOI: 10.1017/S1352465812000884
Abstract: Background: Depressive symptoms are common in schizophrenia. Previous studies have observed that depressive symptoms are associated with both insight and negative appraisals of illness, suggesting that the way in which the person thinks about their illness may influence the occurrence of depressive responses. In affective disorders, one of the most well-established cognitive processes associated with depressive symptoms is rumination, a pattern of perseverative, self-focused negative thinking. Aims: This study examined whether rumination focused on mental illness was predictive of depressive symptoms during the subacute phase of schizophrenia. Method: Forty participants with a diagnosis of schizophrenia and in a stable phase of illness completed measures of rumination, depressive symptoms, awareness of illness, and positive and negative symptoms. Results: Depressive symptoms were correlated with rumination, including when controlling for positive and negative symptoms. The content of rumination frequently focused on mental illness and its causes and consequences, in particular social disability and disadvantage. Depressive symptoms were predicted by awareness of the social consequences of mental illness, an effect that was mediated by rumination. Conclusions: Results suggest that a process of perseveratively dwelling upon mental illness and its social consequences may be a factor contributing to depressive symptoms in people with chronic schizophrenia.
Publisher: Oxford University Press (OUP)
Date: 2019
Publisher: Cambridge University Press (CUP)
Date: 09-10-2013
DOI: 10.1017/S1352465813000817
Abstract: Background: In people who experience auditory verbal hallucinations, beliefs the person holds about their voices appear to be clinically important as mediators of associated distress and disability. Whilst such beliefs are thought to be influenced by broader schematic representations the person holds about themselves and other people, there has been little empirical examination of this, in particular in relation to beliefs about voice intent and the personal meaning of the voice experience. Method: Thirty-four voice hearers with a diagnosis of schizophrenia or schizoaffective disorder completed the Psychotic Symptom Rating Scales and measures of beliefs about voices (Revised Beliefs About Voices Questionnaire, Interpretation of Voices Inventory) and schemas (Brief Core Schema Scales). Results: Beliefs about voices were correlated with both negative voice content and schemas. After controlling for negative voice content, schemas were estimated to predict between 9% and 35% of variance in the six beliefs about voices that were measured. Negative-self schemas were the strongest predictors, and positive-self and negative-other schemas also showed potential relationships with beliefs about voices. Conclusions: Schemas, particularly those regarding the self, are potentially important in the formation of a range of clinically-relevant beliefs about voices.
Publisher: Oxford University Press (OUP)
Date: 16-12-2015
Publisher: Elsevier BV
Date: 04-2014
Publisher: Springer International Publishing
Date: 2023
Publisher: JMIR Publications Inc.
Date: 12-08-2021
DOI: 10.2196/29671
Abstract: During the COVID-19 pandemic, we saw telehealth rapidly become the primary way to receive mental health care. International research has validated many of the benefits and challenges of telehealth known beforehand for specific population groups. However, if telehealth is to assume prominence in future mental health service delivery, greater understanding of its capacity to be used to provide psychosocial support to people with complex and enduring mental health conditions is needed. We focused on an Australian community-managed provider of psychosocial intervention and support. We aimed to understand service user and worker experiences of psychosocial support via telehealth throughout the COVID-19 pandemic. This study was jointly developed and conducted by people with lived experience of mental ill health or distress, mental health service providers, and university-based researchers. Semistructured interviews were conducted between August and November 2020 and explored participant experiences of receiving or providing psychosocial support via telehealth, including telephone, text, and videoconferencing. Qualitative data were analyzed thematically quantitative data were collated and analyzed using descriptive statistics. Service users (n=20) and workers (n=8) completed in idual interviews via telephone or videoconferencing platform. Service users received psychosocial support services by telephone (12/20, 60%), by videoconferencing (6/20, 30%), and by both telephone and videoconferencing (2/20, 10%). Of note, 55% (11/20) of service user participants stated a future preference for in-person psychosocial support services, 30% (6/20) preferred to receive a mixture of in-person and telehealth, and 15% (3/20) elected telehealth only. Two meta-themes emerged as integral to worker and service user experience of telehealth during the pandemic: (1) creating safety and comfort and (2) a whole new way of working. The first meta-theme comprises subthemes relating to a sense of safety and comfort while using telehealth including trusting in the relationship and having and exercising choice and control. The second meta-theme contains subthemes reflecting key challenges and opportunities associated with the shift from in-person psychosocial support to telehealth. Overall, our findings highlighted that most service users experienced telehealth positively, but this was dependent on them continuing to get the support they needed in a way that was safe and comfortable. While access difficulties of a subgroup of service users should not be ignored, most service users and workers were able to adapt to telehealth by focusing on maintaining the relationship and using choice and flexibility to maintain service delivery. Although most research participants expressed a preference for a return to in-person psychosocial support or hybrid in-person and telehealth models, there was a general recognition that intentional use of telehealth could contribute to flexible and responsive service delivery. Challenges to telehealth provision of psychosocial support identified in this study are yet to be fully understood.
Publisher: Elsevier BV
Date: 05-2017
DOI: 10.1016/J.SCHRES.2016.11.019
Abstract: Auditory hallucinations (AH) are a common and distressing experience and patients report distress reduction to be a priority. Relating Therapy adopts a symptom-specific and mechanism focused approach to the reduction of AH distress. We conducted this single-blind, pragmatic, parallel groups, superiority pilot RCT within a single mental health centre in the UK. Patients (18+years) with persistent and distressing AH, irrespective of diagnosis were randomly allocated to receive either Relating Therapy and Treatment-as-usual (RT) or Treatment as-usual alone (TAU). Assessment of outcome was completed pre-randomisation (T0), 16weeks post-randomisation (T1) and 36weeks post-randomisation (T2). The primary outcome was the 5-item Distress scale of the Psychotic Symptoms Rating Scale - Auditory Hallucinations (PSYRATS-AHRS) at T1. We randomly assigned 29 patients to receive RT (n=14) or TAU (n=15). Twenty-five patients (86%) provided complete datasets. Compared with TAU, RT led to reductions in AH distress in the large effect size range across T1 and T2. Our findings suggest that Relating Therapy might be effective for reducing AH distress. A larger, suitably powered phase 3 study is needed to provide a precise estimate of the effects of Relating Therapy for AH distress.
Publisher: Springer Science and Business Media LLC
Date: 27-10-2016
Publisher: Elsevier BV
Date: 12-2019
Publisher: Oxford University Press (OUP)
Date: 13-06-2014
Publisher: Elsevier BV
Date: 09-2014
Publisher: SAGE Publications
Date: 22-11-2020
Abstract: In the quest for new treatment options for depression, attention is being paid to the potential role of psychedelic drugs. Psilocybin is of particular interest given its mechanism of action, its benefits in early trials and its relatively low side effects burden. This viewpoint outlines a number of key issues that remain to be elucidated about its potential use in the clinical environment, including clarification of the profile of people most likely to benefit and those who might experience adverse effects, longer-term outcomes and the role of psychotherapeutic input alongside the drug itself. There are also opportunities to understand better, the neurobiology underpinning its effects.
Publisher: S. Karger AG
Date: 2021
DOI: 10.1159/000517455
Abstract: There has been burgeoning interest in studying hallucinations in psychosis occurring across multiple sensory modalities. The current study aimed to characterize the auditory hallucination and delusion profiles in patients with auditory hallucinations only versus those with multisensory hallucinations. Participants with psychosis were partitioned into groups with voices only (AVH i n /i = 50) versus voices plus hallucinations in at least one other sensory modality (AVH+ i n /i = 50), based on their responses on the Scale for the Assessment of Positive Symptoms (SAPS). Basic demographic and clinical information was collected, and the Questionnaire for Psychotic Experiences (QPE) was used to assess psychosis phenomenology. Relative to the AVH group, greater compliance to perceived commands, auditory illusions, and sensed presences was significantly elevated in the AVH+ group. The latter group also had greater levels of delusion-related distress and functional impairment and was more likely to endorse delusions of reference and misidentification. This preliminary study uncovered important phenomenological differences in those with multisensory hallucinations. Future hallucination research extending beyond the auditory modality is needed.
Publisher: JMIR Publications Inc.
Date: 16-06-2021
DOI: 10.2196/25998
Abstract: e–Mental health resources are increasingly available for people who experience severe mental illness, including those who are users of community mental health services. However, the potential for service users (SUs) living with severe mental illness to use e–mental health resources together with their community mental health workers (MHWs) has received little attention. This study aims to identify how jointly using an interactive website called Self-Management And Recovery Technology (SMART) in a community mental health context influenced therapeutic processes and interactions between SUs and MHWs from their perspective. We conducted a qualitative study using a constructivist grounded theory methodology. Data were collected through in idual semistructured interviews with 37 SUs and 15 MHWs who used the SMART website together for 2 to 6 months. Data analysis involved iterative phases of coding, constant comparison, memo writing, theoretical s ling, and consultation with stakeholders to support the study’s credibility. A substantive grounded theory, discovering ways to keep life on track, was developed, which portrays a shared discovery process arising from the SU-worker-SMART website interactions. The discovery process included choosing to use the website, revealing SUs’ experiences, exploring these experiences, and gaining new perspectives on how SUs did and could keep their lives on track. SUs and MHWs perceived that their three-way interactions were enjoyable, beneficial, and recovery focused when using the website together. They experienced the shared discovery process as relationship building—their interactions when using the website together were more engaging and equal. Jointly using an e–mental health resource elicited recovery-oriented interactions and processes between SUs and MHWs that strengthened their therapeutic relationship in real-world community mental health services. Further work to develop and integrate this novel use of e–mental health in community mental health practice is warranted.
Publisher: Springer Science and Business Media LLC
Date: 07-09-2016
Publisher: Oxford University Press (OUP)
Date: 03-2017
Publisher: Springer Science and Business Media LLC
Date: 13-07-2018
Publisher: Elsevier BV
Date: 03-2021
Publisher: Oxford University Press (OUP)
Date: 04-2018
Publisher: BMJ
Date: 06-2020
DOI: 10.1136/BMJOPEN-2019-036453
Abstract: The sustainability of healthcare delivery systems is challenged by ageing populations, complex systems, increasing rates of chronic disease, increasing costs associated with new medical technologies and growing expectations by healthcare consumers. Healthcare programmes, innovations and interventions are increasingly implemented at the front lines of care to increase effectiveness and efficiency however, little is known about how sustainability is conceptualised and measured in programme evaluations. We aimed to describe theoretical frameworks, definitions and measures of sustainability, as applied in published evaluations of healthcare improvement programmes and interventions. Systematic integrative review. We searched six academic databases, CINAHL, Embase, Ovid MEDLINE, Emerald Management, Scopus and Web of Science, for peer-reviewed English journal articles (July 2011–March 2018). Articles were included if they assessed programme sustainability or sustained outcomes of a programme at the healthcare system level. Six reviewers conducted the abstract and full-text review. Data were extracted on study characteristics, definitions, terminology, theoretical frameworks, methods and tools. Hawker’s Quality Assessment Tool was applied to included studies. Of the 92 included studies, 75.0% were classified as high quality. Twenty-seven (29.3%) studies provided 32 different definitions of sustainability. Terms used interchangeably for sustainability included continuation, maintenance, follow-up or long term. Eighty studies (87.0%) clearly reported the timepoints at which sustainability was evaluated: 43.0% at 1–2 years and 11.3% at months. Eighteen studies (19.6%) used a theoretical framework to conceptualise or assess programme sustainability, including frameworks that were not specifically designed to assess sustainability. The body of literature is limited by the use of inconsistent definitions and measures of programme sustainability. Evaluations of service improvement programmes and interventions seldom used theoretical frameworks. Embedding implementation science and healthcare service researchers into the healthcare system is a promising strategy to improve the rigour of programme sustainability evaluations.
Publisher: Cambridge University Press (CUP)
Date: 09-07-2018
DOI: 10.1017/S1352465818000425
Abstract: Background: A prominent area of advancement in the psychological treatment for people with persisting psychosis has been the application of mindfulness-based therapies. Recent literature has recommended the investigation of focused mindfulness interventions for voices (auditory hallucinations) as a specific experience. To date, only mindfulness programs in group format have been examined. Aims: This non-randomized pilot study aimed to assess the acceptability, feasibility and potential outcomes of an in idual mindfulness program for persistent voices on the negative impact of voices on the subjective experience of mental health and wellbeing, depression and voice-related distress and disruption. Also, it aimed to identify potential psychological and neurocognitive mechanisms of change. Method: A new 4-week in idual Mindfulness Program for Voices (iMPV) was developed, and piloted with a group of 14 participants with a schizophrenia-spectrum disorder and persisting voices. Participants completed clinical and neurocognitive measures pre- and post-intervention and at 2-month follow-up. Results: Results revealed low attrition rates, high formal practice engagement levels and positive participant feedback. Pre–post outcomes suggested small to moderate effects for a reduction in the negative impact of voices on experience, depression and disruption. Large effects for changes in mindful responding and attentional switching were also identified. Conclusions: Our findings suggest that this novel treatment protocol is appropriate, engaging and safe for persistent voice hearers. Findings for mindful responding and attentional switching suggest these to be potential mechanisms of change for further investigation. Further RCTs are warranted to ascertain the feasibility and efficacy for focused mindfulness interventions for voices of in idual format.
Publisher: Royal College of Psychiatrists
Date: 11-2019
DOI: 10.1192/BJO.2019.72
Abstract: Mental health patients can experience involuntary treatment as disempowering and stigmatising, and contact with recovered peers is cited as important for countering stigma and fostering agency and autonomy integral to recovery. To advance understanding of the interaction between involuntary treatment and contact with recovered peers, and explore hypothesised relationships to mechanisms of self-evaluation relevant to recovery. Eighty-nine adults diagnosed with serious mental illness completed items to assess involuntary treatment experience and the extent of prior contact with recovered peers, the Internalised Stigma of Mental Illness Scale, the Self-efficacy for Personal Recovery Scale, the Questionnaire about the Process of Recovery and relevant demographic and clinical scales. Contact with recovered peers was found to moderate the effects of involuntary treatment on internalised stigma. Sequential conditional process models (i.e. moderated mediation) then demonstrated that conditional internalised stigma (i.e. moderated by contact with recovered peers) mediated the indirect effect of involuntary treatment on recovery-specific self-efficacy, which in turn influenced recovery. Compared with those with low contact with recovered peers, recovery scores were 3.54 points higher for those with high contact. Although study methods limit causative conclusions, findings are consistent with proposals that contact with recovered peers may be helpful for this patient group, and suggest this may be particularly relevant for those with involuntary treatment experience. Directions for future research, to further clarify measurement and conceptual tensions relating to the study of (dis)empowering experiences in mental health services, are discussed in detail.
Publisher: Elsevier BV
Date: 02-2021
Publisher: Elsevier
Date: 2020
Publisher: Royal College of Psychiatrists
Date: 02-2017
DOI: 10.1192/BJP.BP.116.182865
Abstract: The efficacy of acceptance and commitment therapy (ACT) in psychosis has been reported but not for medication-resistant psychosis. To test the efficacy of ACT in a s le of community-residing patients with persisting psychotic symptoms. (Australian New Zealand Clinical Trials Registry: ACTRN12608000210370.) The primary outcome was overall mental state at post-therapy (Positive and Negative Syndrome Scale –total) secondary outcomes were psychotic symptom dimensions and functioning. In total, 96 patients were randomised to ACT ( n = 49) or befriending ( n = 47). Symptom, functioning and process measures were administered at baseline, post-therapy and 6 months later. There was no group difference on overall mental state. In secondary analyses the ACT group showed greater improvement in positive symptoms and hallucination distress at follow-up: Cohen's d = 0.52 (95% CI 0.07–0.98) and 0.65 (95% CI 0.24–1.06), respectively. Improvements reflected the treatment focus on positive symptoms however, absence of process-measure changes suggests that the ACT intervention used did not manipulate targeted processes beyond befriending. Symptom-specific therapy refinements, improved investigation of process and attention to cognitive functioning and dose are warranted in future research.
Publisher: Springer Science and Business Media LLC
Date: 13-09-2022
DOI: 10.1186/S13063-022-06683-1
Abstract: Many patients suffering from schizophrenia spectrum disorders continue having distressing auditory hallucinations in spite of treatment with antipsychotic medication. The aim of this trial is to examine the effect of a targeted virtual reality therapy for persistent auditory hallucinations in in iduals with psychosis. The trial explores whether this type of therapy can decrease the severity, frequency and distress of auditory hallucinations and, additionally, whether it can reduce clinical symptoms and enhance daily functioning in in iduals with psychosis. The study is a randomised, assessor-blinded parallel-group superiority clinical trial, allocating a total of 266 patients to either the experimental intervention or supportive counselling. The participants will be randomised to either (1) seven sessions of virtual reality therapy or (2) seven sessions of supportive counselling to be delivered within the first 12 weeks after inclusion in the study. All participants will be assessed at baseline and 12 and 24 weeks post-baseline. Independent assessors blinded to the treatment allocation will evaluate the outcome. The primary outcome is the level of auditory hallucinations measured with the Psychotic Symptoms Rating Scales (PSYRATS-AH) total score at the cessation of treatment at 12 weeks. Secondary outcomes are frequency of auditory hallucinations, the distress caused by auditory hallucinations, perceived voice power, patient acceptance of voices, patients’ ability to respond to voices in an assertive way and social and daily function. Promising evidence of the efficacy of this immersive virtual reality-based therapy for auditory hallucinations exist, but evidence needs to be established in a large, methodological rigorous trial. If the therapy proves to be beneficial in reducing the severity of refractory auditory hallucinations, a large group of patients with schizophrenia and related disorders could be the target group of this short-term psychotherapeutic intervention.
Publisher: Wiley
Date: 04-2021
DOI: 10.1111/JMFT.12518
Abstract: The delivery of videoconferencing psychotherapy (VCP) has been found to be an efficacious, acceptable and feasible treatment modality for in idual therapy. However, less is known about the use of VCP for couple and family therapy (CFT). The focus of this systematic review was to examine the efficacy, feasibility and acceptability of using VCP as a treatment delivery modality for CFT. A systematic search was conducted, data relating to efficacy, feasibility and acceptability were extracted from included studies. The search returned 7,112 abstracts, with 37 papers (0.005%) included. The methods of the review were pre‐registered (PROSPERO CRD42018106137). VCP for CFT was demonstrated to be feasible and acceptable. A meta‐analysis was not conducted however, results from the included studies indicate that VCP is an efficacious delivery method for CFT. Recommendations for future research and implications regarding clinical practice are made, which may be of interest to practitioners given the COVID‐19 pandemic.
Publisher: Oxford University Press (OUP)
Date: 21-03-2023
Abstract: There is limited evidence to guide the approaches to clozapine treatment. Accordingly, an international initiative was undertaken with the aim of developing consensus recommendations for the optimization of clozapine monotherapy. We conducted an online Delphi survey among members of the Treatment Response and Resistance in Psychosis (TRRIP) working group comprising experts from twenty-nine countries. The threshold criterion for a consensus recommendation was ≥ 75% agreement (“agree” and “strongly agree” responses) on a question. Agreement of ≥ 50% but & 75% in a second or third Delphi round was deemed to provide guidance. Forty-nine (first round), 32 (second round), and 48 (third round) of the 91 current TRRIP members participated. Expert recommendations at ≥ 75% comprised second-line treatment with clozapine in cases of persistent positive symptoms with co-occurring extrapyramidal symptoms, tar e dyskinesia, or suicidality/aggression. There was considerable disagreement on myocarditis screening parameters. The management of somatic and neuropsychiatric adverse drug reactions warrants further research for more evidence-based recommendations. Rechallenge with clozapine was recommended for eosinophilia, sinus tachycardia and fever and guidance (agreement ≥ 50%) was reached for pneumonia and thrombocytopenia. Given the limited evidence available, this consensus-based series of recommendations and guidance statements supports clinical decision-making to optimize clozapine monotherapy and provides guidance for future research in treatment-resistant schizophrenia.
Publisher: Informa UK Limited
Date: 07-09-2023
DOI: 10.1080/09638237.2022.2118688
Abstract: Digital technologies enable the dissemination of multimedia resources to support adults with serious mental illness in their self-management and personal recovery. However, delivery needs to accommodate engagement and accessibility challenges. We examined how a digital resource, designed for mental health workers and consumers to use together in session, would be used in routine practice. Thirty consumers and their workers participated. The web-based resource, Self-Management And Recovery Technology (SMART), was available to use within and between sessions, for a 6-month period. Workers initiated in-session use where relevant. Feasibility was explored via uptake and usage data and acceptability and impact via questionnaires. A pre-post design assessed recovery outcomes for consumers and relationship outcomes for consumers and workers. In participating mental health practitioner-consumer dyads, consumers gave strong acceptability ratings, and reported improved working relationships. However, the resource was typically used in one-third or fewer appointments, with consumers expressing a desire for greater in-session use. Improvements in self-rated personal recovery were not observed, possibly contributed to by low usage. In-session use was found helpful by consumers but may be constrained by other demands in mental health care delivery: collaborative use may require dedicated staff time or more formal implementation.
Publisher: SAGE Publications
Date: 31-01-2017
Abstract: The Internet is increasingly used in mental health service delivery, but there are significant potential barriers to Internet access for persons with severe mental illness (SMI). There is a need to understand this group’s access to, and confidence with using, the Internet, and current views on using online resources as part of mental healthcare. A survey was conducted of 100 consumers attending a specialist mental health service in Melbourne, Australia. Approximately three-quarters of participants had regular access to the Internet, and two-thirds used the Internet weekly or more. Half of the s le used email at least weekly, and a third were regular users of social networking sites. Internet access was often via mobile devices. Only a minority of participants used the Internet for mental health information, with video streaming and general websites accessed more often than peer forums for mental health content. Most participants were positive about their mental health worker using tablet computers with them in appointments for delivery of mental health materials. Most people with SMI are active Internet users and, therefore, able to use interventions online.
Publisher: Frontiers Media SA
Date: 2013
Publisher: Elsevier BV
Date: 05-2023
Publisher: Oxford University Press (OUP)
Date: 13-06-2014
Publisher: Frontiers Media SA
Date: 2013
Publisher: Wiley
Date: 19-11-2022
DOI: 10.1111/PAPT.12372
Abstract: There is growing evidence of a link between the experience of hearing voices and past traumatic events, and trauma‐focussed psychological interventions are being applied to hearing voices as an emerging treatment direction. To inform the ongoing development and implementation of this application, there is a need to understand clients’ therapy experiences. Qualitative study exploring the experience of people who received an intervention for voices linked to a previous traumatic event. Ten participants experiencing voices with some connection to a previous traumatic event participated in in idual semi‐structured interviews following six sessions of imaginal exposure, an exposure‐based trauma‐focussed intervention. Participant responses were analysed using thematic analysis. Participants reported a range of benefits from the intervention, including improved mental health, reduction of distressing voice‐hearing experiences, and increased clarity of the traumatic event. The therapy was perceived as distinctly different to previous therapy experiences, and participants noted that therapy could be intense and challenging, yet helpful later. Participants also reported that outside circumstances impacted on their progress in therapy and their voice‐hearing experience. The findings suggest that exposure‐based trauma‐focussed therapies may be beneficial for people who hear trauma‐related voices. However, this intervention can be intense and clinicians and consumers need to consider the timing of delivery, and pay attention to internal and external resources that can increase participants’ sense of safety. Imaginal exposure may be an effective intervention for people who hear voices that they perceive to be associated with a past traumatic event. Positive changes associated with the intervention may be highly variable between in iduals, and encompass changes in sense of self, changes to internal states, and changes to voice‐hearing experience. Imaginal exposure interventions may involve some temporary discomfort and symptom exacerbation, which may affect the acceptability of the intervention. This needs to be considered in both future research and clinical delivery.
Publisher: Informa UK Limited
Date: 03-2016
DOI: 10.1111/AJPY.12092
Publisher: Cambridge University Press (CUP)
Date: 26-09-2023
Publisher: Wiley
Date: 29-07-2022
DOI: 10.1111/PAPT.12415
Abstract: Recovery‐oriented perspectives have become accepted worldwide as an alternative to the biomedical approach to conceptualizing and managing severe mental health problems. It has been proposed that one advantage of this is to support self‐efficacy amongst people with a lived experience of psychosis, especially when recovery messages are presented by lived experience peers. The aim of the present study was to investigate the proposed psychological benefits of the recovery paradigm, by testing for possible differential impacts of recovery versus biomedical messages on self‐efficacy beliefs and positive emotional state amongst people with experience of psychosis. It was hypothesized that (1) recovery‐oriented messages, when presented by lived experience peers, would generate improvements in self‐efficacy and positive emotions relative to biomedical messages presented by a professional and (2) recovery‐oriented messages delivered by a professional would generate improvements in self‐efficacy and positive emotions relative to biomedical messages delivered by a professional. We also explored whether recovery‐oriented messages were more impactful when delivered by a lived experience peer versus a professional. Experimental design with three within‐subject video‐based conditions. Fifty‐three participants with lived experience of psychosis viewed three videos: (i) people with lived experience sharing their experiences of recovery (ii) mental health professionals presenting traditional biomedical conceptualizations of psychosis and (iii) mental health professionals presenting recovery perspectives. Participants provided baseline clinical and demographic information, and post‐viewing ratings of experienced changes in self‐efficacy and emotional state. Hypothesis 1 was supported: both self‐efficacy and positive emotions were significantly increased by a video of peers sharing personal recovery stories relative to professionals presenting biomedical messages. Hypothesis 2 was partially supported: when comparing videos of recovery versus biomedical messages delivered by professionals, significant relative benefits were found for positive emotions, but not self‐efficacy. This experimental investigation generated a pattern of findings broadly supportive of the assumed psychological benefits of the recovery paradigm for people with lived experiences of psychosis. Findings must be interpreted with caution given the limitations of the present design, but encourage further experimental research to directly test the interpersonal impacts of the recovery paradigm.
Publisher: Elsevier BV
Date: 12-2020
Publisher: Elsevier BV
Date: 04-2016
Publisher: Elsevier BV
Date: 06-2016
DOI: 10.1016/J.PSYCHRES.2016.03.052
Abstract: Body image concerns are common in the general population and in some mental illnesses reach pathological levels. We investigated whether dysmorphic concern with appearance (a preoccupation with minor or imagined defects in appearance) is explained by psychotic processes in a community s le. In a cross-sectional design, two hundred and twenty six participants completed an online survey battery including: The Dysmorphic Concern Questionnaire the Peters Delusional inventory the Aberrant Salience Inventory and the Depression, Anxiety, Stress Scale. Participants were native English speakers residing in Australia. Dysmorphic concern was positively correlated with delusional proneness, aberrant salience and negative emotion. Regression established that negative emotion and delusional proneness predicted dysmorphic concern, whereas, aberrant salience did not. Although delusional proneness was related to body dysmorphia, there was no evidence that it was related to aberrant salience. Understanding the contribution of other psychosis processes, and other health related variables to the severity of dysmorphic concern will be a focus of future research.
Publisher: Elsevier BV
Date: 11-2018
DOI: 10.1016/J.PSYCHRES.2018.08.093
Abstract: The personal recovery movement in mental health has emphasised consumers' in idual responsibility and autonomy in defining and directing their own recovery journey. Self-efficacy, or an in idual's belief that they can achieve their desired outcomes, is likely to be a key predictor of recovery success. However, there is no established measure of self-efficacy for personal recovery. The Self-Efficacy for Personal Recovery Scale was developed and its psychometric properties evaluated as part of a broader research program investigating a recovery-focused digital intervention in psychosis. Scale reliability and validity were investigated in a s le of 178 adults with persisting psychosis, and test-retest reliability was evaluated in a subset of 32 participants. The scale showed high internal consistency, test-retest reliability, and convergent validity, including correlating positively with hope, personal recovery, and generalised self-efficacy, whilst showing independence from social desirability, insight, and positive symptoms. This measure may be useful for research into the processes underlying recovery, and for understanding how self-efficacy for personal recovery may be enhanced in people with severe mental illness.
Publisher: Frontiers Media SA
Date: 03-03-2017
Publisher: JMIR Publications Inc.
Date: 06-09-2019
Abstract: egular mindfulness practice has been demonstrated to be beneficial for mental health, but mindfulness can be challenging to adopt, with environmental and personal distractors often cited as challenges. Virtual reality (VR) may address these challenges by providing an immersive environment for practicing mindfulness and by supporting the user to orient attention to the present moment within a tailored virtual setting. However, there is currently a limited understanding of the ways in which VR can support or hinder mindfulness practice. Such an understanding is required to design effective VR apps while ensuring that VR-supported mindfulness is acceptable to end users. his study aimed to explore how VR can support mindfulness practice and to understand user experience issues that may affect the acceptability and efficacy of VR mindfulness for users in the general population. s le of 37 participants from the general population trialed a VR mindfulness app in a controlled laboratory setting. The VR app presented users with an omnidirectional video of a peaceful forest environment with a guided mindfulness voiceover that was delivered by a male narrator. Scores on the State Mindfulness Scale, Simulator Sickness Questionnaire, and single-item measures of positive and negative emotion and arousal were measured pre- and post-VR for all participants. Qualitative feedback was collected through interviews with a subset of 19 participants. The interviews sought to understand the user experience of mindfulness practice in VR. tate mindfulness ( i P /i & .001 Cohen i d /i =1.80) and positive affect ( i P /i =.006 i r /i =.45) significantly increased after using the VR mindfulness app. No notable changes in negative emotion, subjective arousal, or symptoms of simulator sickness were observed across the s le. Participants described the user experience as relaxing, calming, and peaceful. Participants suggested that the use of VR helped them to focus on the present moment by using visual and auditory elements of VR as attentional anchors. The sense of presence in the virtual environment (VE) was identified by participants as being helpful to practicing mindfulness. Interruptions to presence acted as distractors. Some uncomfortable experiences were discussed, primarily in relation to video fidelity and the weight of the VR headset, although these were infrequent and minor. his study suggests that an appropriately designed VR app can support mindfulness practice by enhancing state mindfulness and inducing positive affect. VR may help address the challenges of practicing mindfulness by creating a sense of presence in a tailored VE by allowing users to attend to visual and auditory anchors of their choice and by reducing the scope of the content in users’ mind-wandering. VR has the unique capability to combine guided mindfulness practice with tailored VEs that lend themselves to support in iduals to focus attention on the present moment.
Publisher: Frontiers Media SA
Date: 23-12-2016
Publisher: JMIR Publications Inc.
Date: 21-01-2020
DOI: 10.2196/14996
Abstract: Videoconferencing psychotherapy (VCP) is a growing practice among mental health professionals. Early adopters have predominantly been in private practice settings, and more recent adoption has occurred in larger organizations, such as the military. The implementation of VCP into larger health service providers in the public sector is an important step in reaching and helping vulnerable and at-risk in iduals however, several additional implementation challenges exist for public sector organizations. The aim of this study was to offer an implementation model for effectively introducing VCP into public sector organizations. This model will also provide practical guidelines for planning and executing an embedded service trial to assess the effectiveness of the VCP modality once implemented. An iterative search strategy was employed, drawing on multiple fields of research across mental health, information technology, and organizational psychology. Previous VCP implementation papers were considered in detail to provide a synthesis of the barriers, facilitators, and lessons learned from the implementation attempts in the military and other public sector settings. A model was formulated, which draws on change management for technology integration and considers the specific needs for VCP integration in larger organizations. A total of 6 phases were formulated and were further broken down into practical and measurable steps. The model explicitly considers the barriers often encountered in large organizational settings and suggests steps to increase facilitating factors. Although the model proposed is time and resource intensive, it draws on a comprehensive understanding of larger organizational needs and the unique challenge that the introduction of VCP presents to such organizations.
Publisher: Wiley
Date: 14-02-2022
DOI: 10.1111/PAPT.12384
Abstract: Auditory verbal hallucinations (AVHs) occur as a symptom in various mental disorders, and show different phenomenological aspects, depending on their underlying psychopathology. Anxiety and depression, which are known to be involved in the development of AVHs, are suggested to lify a vicious cycle in which negative interpretations of daily experiences feed into the formation of negative core schemas about the self and others. However, the way in which these variables interrelate is still unknown. Therefore, our aim was to determine the specific roles of anxiety and depression in the relationship between core schemas and emotional aspects of AVHs for three groups (non‐clinical voice hearers, affective voice hearers and non‐affective voice hearers). Positive and negative core schemas of the self and others were tested as predictors of emotional distress due to AVHs, examining anxiety and depression separately as potential mediators. Results showed full mediating effects of depression in non‐affective voice hearers in the relationship between negative core schemas and AVH distress, but not in affective voice hearers. Anxiety was not a mediator in any of the groups. These findings suggest different emotional mechanisms depending on the underlying psychopathology.
Publisher: Elsevier BV
Date: 09-2021
Publisher: Elsevier BV
Date: 08-2019
DOI: 10.1016/J.PSYCHRES.2019.05.034
Abstract: As digital interventions are beginning to be developed to support self-management of psychosis, it is important to understand how illness-related and in idual factors may affect internet use and engagement with digital mental health resources among people with psychotic disorders. This study aimed to identify demographic, clinical, and personal variables associated with overall and mental health-related internet use in a s le of 189 adult community mental health service users with nonaffective and affective psychotic disorders. Among participants who regularly used the internet (87.3%), most (67.9%) reported using the internet for mental health information. Higher frequency of overall internet use was predicted by younger age, completion of post-secondary education, and less severe negative symptoms. Internet use for mental health information was predicted by younger age, higher levels of overall internet use, current productive employment, and higher loneliness. This study is the first to quantitatively examine how clinical and personal measures relate to overall and mental health-related internet use in people with psychosis. Although cognitive difficulties and negative symptoms impacted overall internet use, these disorder-related difficulties did not further impact internet use for mental health information. Digital mental health resources should be designed to optimise engagement for this population.
Publisher: Informa UK Limited
Date: 09-2012
Publisher: Frontiers Media SA
Date: 2015
Publisher: American Psychological Association (APA)
Date: 10-2021
DOI: 10.1037/CCP0000684
Publisher: Oxford University Press (OUP)
Date: 09-08-2020
Abstract: Hallucinations can occur in different sensory modalities, both simultaneously and serially in time. They have typically been studied in clinical populations as phenomena occurring in a single sensory modality. Hallucinatory experiences occurring in multiple sensory systems—multimodal hallucinations (MMHs)—are more prevalent than previously thought and may have greater adverse impact than unimodal ones, but they remain relatively underresearched. Here, we review and discuss: (1) the definition and categorization of both serial and simultaneous MMHs, (2) available assessment tools and how they can be improved, and (3) the explanatory power that current hallucination theories have for MMHs. Overall, we suggest that current models need to be updated or developed to account for MMHs and to inform research into the underlying processes of such hallucinatory phenomena. We make recommendations for future research and for clinical practice, including the need for service user involvement and for better assessment tools that can reliably measure MMHs and distinguish them from other related phenomena.
Publisher: Routledge
Date: 15-12-2014
Publisher: Frontiers Media SA
Date: 18-11-2016
Publisher: Elsevier BV
Date: 06-2015
DOI: 10.1016/J.JAD.2015.02.024
Abstract: People in the late stage of bipolar disorder (BD) experience elevated relapse rates and poorer quality of life (QoL) compared with those in the early stages. Existing psychological interventions also appear less effective in this group. To address this need, we developed a new online mindfulness-based intervention targeting quality of life (QoL) in late stage BD. Here, we report on an open pilot trial of ORBIT (online, recovery-focused, bipolar in idual therapy). Inclusion criteria were: self-reported primary diagnosis of BD, six or more episodes of BD, under the care of a medical practitioner, access to the internet, proficient in English, 18-65 years of age. Primary outcome was change (baseline - post-treatment) on the Brief QoL.BD (Michalak and Murray, 2010). Secondary outcomes were depression, anxiety, and stress measured on the DASS scales (Lovibond and Lovibond, 1993). Twenty-six people consented to participate (Age M=46.6 years, SD=12.9, and 75% female). Ten participants were lost to follow-up (38.5% attrition). Statistically significant improvement in QoL was found for the completers, t(15)=2.88, 95% CI:.89-5.98, p=.011, (Cohen׳s dz=.72, partial η(2)=.36), and the intent-to-treat s le t(25)=2.65, 95% CI:.47-3.76, (Cohen׳s dz=.52 partial η(2)=.22). A non-significant trend towards improvement was found on the DASS anxiety scale (p=.06) in both completer and intent-to-treat s les, but change on depression and stress did not approach significance. This was an open trial with no comparison group, so measured improvements may not be due to specific elements of the intervention. Structured diagnostic assessments were not conducted, and interpretation of effectiveness was limited by substantial attrition. Online delivery of mindfulness-based psychological therapy for late stage BD appears feasible and effective, and ORBIT warrants full development. Modifications suggested by the pilot study include increasing the 3 weeks duration of the intervention, adding cautions about the impact of extended meditations, and addition of coaching support/monitoring to optimise engagement.
Publisher: Oxford University Press (OUP)
Date: 18-05-2020
Abstract: Evidence for the management of inadequate clinical response to clozapine in treatment-resistant schizophrenia is sparse. Accordingly, an international initiative was undertaken with the aim of developing consensus recommendations for treatment strategies for clozapine-refractory patients with schizophrenia. We conducted an online survey among members of the Treatment Response and Resistance in Psychosis (TRRIP) working group. An agreement threshold of ≥75% (responses “agree” + “strongly agree”) was set to define a first-round consensus. Questions achieving agreement or disagreement proportions of & % in the first round, were re-presented to develop second-round final consensus recommendations. Forty-four (first round) and 49 (second round) of 63 TRRIP members participated. Expert recommendations at ≥75% agreement included raising clozapine plasma levels to ≥350 ng/ml for refractory positive, negative, and mixed symptoms. Where plasma level-guided dose escalation was ineffective for persistent positive symptoms, waiting for a delayed response was recommended. For clozapine-refractory positive symptoms, combination with a second antipsychotic (amisulpride and oral aripiprazole) and augmentation with ECT achieved consensus. For negative symptoms, waiting for a delayed response was recommended, and as an intervention for clozapine-refractory negative symptoms, clozapine augmentation with an antidepressant reached consensus. For clozapine-refractory suicidality, augmentation with antidepressants or mood-stabilizers, and ECT met consensus criteria. For clozapine-refractory aggression, augmentation with a mood-stabilizer or antipsychotic medication achieved consensus. Generally, cognitive-behavioral therapy and psychosocial interventions reached consensus. Given the limited evidence from randomized trials of treatment strategies for clozapine-resistant schizophrenia (CRS), this consensus-based series of recommendations provides a framework for decision making to manage this challenging clinical situation.
Publisher: JMIR Publications Inc.
Date: 18-10-2019
Abstract: eb-based interventions are increasingly being used for in iduals with serious mental illness, including psychosis, and preliminary evidence suggests clinical benefits. To achieve such benefits, in iduals must have some level of engagement with the intervention. Currently, little is known about what influences engagement with web-based interventions for in iduals with psychotic disorders. his study aimed to explore users' perspectives on what influenced engagement with a web-based intervention for psychosis. qualitative design was employed using semistructured telephone interviews. Participants were 17 adults with psychosis who had participated in a trial examining engagement with a self-guided, web-based intervention promoting personal recovery and self-management of mental health. e identified 2 overarching themes: i challenges to using the website /i and i factors supporting persistence /i . Both of the main themes included several subthemes related to both user-related factors (eg, mental health, personal circumstances, approach to using the website) and users’ experience of the intervention (eg, having experienced similar content previously or finding the material confronting). n iduals with psychosis experienced several challenges to ongoing engagement with a web-based intervention. Adjunctive emails present an important design feature to maintain interest and motivation to engage with the intervention. However, fluctuations in mental health and psychosocial difficulties are a significant challenge. Design and implementation considerations include flexible interventions with tailoring opportunities to accommodate changeable circumstances and in idual preferences.
Publisher: SAGE Publications
Date: 20-04-2015
Abstract: Although there is evidence of both clinical and personal recovery from distressing voices, the process of recovery over time is unclear. Narrative inquiry was used to investigate 11 voice-hearers’ lived experience of recovery. After a period of despair/exhaustion, two recovery typologies emerged: (a) turning toward/empowerment, which involved developing a normalized account of voices, building voice-specific skills, integration of voices into daily life, and a transformation of identity, and (b) turning away rotective hibernation, which involved harnessing all available resources to survive the experience, with the importance of medication in recovery being emphasized. Results indicated the importance of services being sensitive and responsive to a person’s recovery style at any given time and their readiness for change. Coming to hold a normalized account of voice-hearing and the self and witnessing of preferred narratives by others were essential in the more robust turning toward recovery typology.
Publisher: Frontiers Media SA
Date: 02-07-2020
Publisher: JMIR Publications Inc.
Date: 24-01-2018
Abstract: igital interventions offer an innovative way to make the experiences of people living with mental illness available to others. As part of the Self-Management And Recovery Technology (SMART) research program on the use of digital resources in mental health services, an interactive website was developed including videos of people with lived experience of mental illness discussing their recovery. These peer videos were designed to be watched on a tablet device with a mental health worker, or independently. ur aim was to explore how service users experienced viewing the lived experience videos on this interactive website, as well as its influence on their recovery journey. n total, 36 service users with experience of using the website participated in in idual semistructured qualitative interviews. All participants had experience of psychosis. Data analysis occurred alongside data collection, following principles of constructivist grounded theory methodology. ccording to participants, engaging with lived experience videos was a pivotal experience of using the website. Participants engaged with peers through choosing and watching the videos and reflecting on their own experience in discussions that opened up with a mental health worker. Benefits of seeing others talking about their experience included “being inspired,” “knowing I’m not alone,” and “believing recovery is possible.” Experiences of watching the videos were influenced by the participants’ intrapersonal context, particularly their ways of coping with life and use of technology. The interpersonal context of watching the videos with a worker, who guided website use and facilitated reflection, enriched the experience. ngaging with lived experience videos was powerful for participants, contributing to their feeling connected and hopeful. Making websites with lived experience video content available to service users and mental health workers demonstrates strong potential to support service users’ recovery.
Publisher: Wiley
Date: 13-04-2021
DOI: 10.1111/PAPT.12276
Publisher: Elsevier BV
Date: 02-2021
Publisher: Wiley
Date: 11-2009
Publisher: JMIR Publications Inc.
Date: 24-01-2018
Publisher: Oxford University Press (OUP)
Date: 2019
Publisher: Frontiers Media SA
Date: 2015
Publisher: Oxford University Press (OUP)
Date: 21-07-2016
Publisher: Elsevier BV
Date: 08-2020
Publisher: Informa UK Limited
Date: 05-2018
DOI: 10.1080/00332747.2018.1492852
Abstract: The Internet offers a growing range of e-mental health resources for people experiencing severe mental illness. How these resources may be used in face-to-face interactions with consumers in mental health practice is not well understood. This article explores mental health workers' current use of online resources and their views about integrating e-mental health resources for promoting self-management and recovery into community-based practice. A total of 37 mental health workers from six services attended focus groups to discuss their views about using online and e-mental health resources in face-to-face interactions with consumers. Data were analyzed using qualitative content analysis. Participants described accessing Internet information but having little opportunity to use online resources with consumers. Limited access to mobile technology and perceptions that consumers lacked technological experience constrained current use. Three approaches to using e-mental health resources were perceived: directing, collaborating, and empowering. Access to mobile technology within worker-consumer interactions was identified as a potential catalyst for creating recovery-oriented therapeutic relationships. Mental health workers are ready to grasp opportunities to use e-mental health resources with consumers. This has the potential to develop and strengthen collaborative, partnership-based relationships if mental health services support workers and consumers to use online resources together.
Publisher: Wiley
Date: 25-05-2013
DOI: 10.1111/BJC.12020
Abstract: This study explored specific and differential effects of metacognitive beliefs on proneness to both hallucinations and delusions in a general population s le, including a control for the alternate symptom. The study then examined whether similar findings were reproduced in a s le of people with psychotic disorders. Linear and hierarchical regressions were used to determine the role of metacognitive beliefs in the proneness to symptoms, whilst ANCOVAs analysed group differences. Participants were recruited to a non-clinical s le (N = 133) and a psychosis s le (N = 100). Both groups completed the Launay-Slade Hallucinations Scale-Revised (Laroi et al., Eur. Psychiatry, 19, 15), the Peters Delusions Inventory (Peters et al., Schizophr. Bull., 25, 553), and the Metacognitions Questionnaire-30 (Wells & Cartwright-Hatton, Behav. Res. Ther., 42, 385). Metacognitions were predictive of both hallucination- and delusion-proneness in the non-clinical s le. Controlled analyses in the non-clinical s le revealed specific effects: low cognitive confidence (CC) predicted hallucination-proneness, whilst negative beliefs about the uncontrollability and danger of thoughts (NBUD) predicted delusion-proneness. Mean ratings on NBUD, low CC, and need to control thoughts were elevated in the psychosis s le however, after controlling for comorbid symptoms, no metacognitive belief predicted symptom-specific vulnerability in the clinical s le. The pattern of findings provided little support for Morrison's theoretical model of symptom-proneness. Metacognitive beliefs may be related to sub-acute vulnerability to psychosis symptoms however, the specificity of the relationship between in idual metacognitive beliefs and positive psychosis symptoms appeared no longer significant in psychosis patients. The possibility that these metacognitive beliefs are evoked by psychotic experiences, rather than primarily functioning as a driver of them, warrants greater attention. Metacognitive beliefs appear at least equally associated with delusion-proneness as hallucination-proneness. Negative metacognitive beliefs appear more central to delusion-proneness than hallucination-proneness in the general population. When controlling for alternate symptom, no in idual metacognitive belief appears reliably able to predict symptom-proneness in psychosis patients. Consistent with existing literature on metacognitions in psychosis, this study adopted a cross-sectional design, meaning we were unable to determine the causal direction of the observed associations between metacognitive beliefs and symptom-proneness. Although a strength of this study design was its control for alternate psychotic symptoms, we did not control for non-psychotic symptoms, particularly, anxiety and depression. The symptom measures used were developed primarily for assessment of psychosis-proneness within the general population thus, their use by people with established psychosis may have been less sensitive to clinical manifestations of these phenomena.
Publisher: SAGE Publications
Date: 23-04-2013
Publisher: Elsevier BV
Date: 02-2018
DOI: 10.1016/J.SCHRES.2017.05.023
Abstract: In promoting optimal recovery in persons with psychosis, psychological interventions have become a key element of treatment, with cognitive behavioural therapy being widely recommended in clinical practice guidelines. One key area of development has been the trialling of "third wave" cognitive behavioural interventions, which promote mindfulness, acceptance and compassion as means of change. Trials to date have demonstrated encouraging findings, with beneficial effects observed on measures of psychotic symptoms. This meta-analysis evaluated the efficacy of third wave interventions for the treatment of psychosis in randomised controlled trials, with psychotic symptoms as the primary outcome. Overall, 10 studies were included. The primary outcome demonstrated a small but significant effect (g=0.29) for third wave interventions compared with control post-treatment. Trials of group format mindfulness-based interventions showed larger effects (g=0.46) than in idual acceptance and commitment therapy based interventions (g=0.08), although methodological differences between trials were noted. Among secondary outcomes, a moderate, significant treatment effect (g=0.39) was found for depressive symptoms, but no significant effects were found on specific measures of positive and negative symptoms, hallucination distress, or functioning/disability. A moderate effect on mindfulness (g=0.56) was observed, but not on acceptance. Overall, findings indicate that third wave interventions show beneficial effects on symptoms in persons with psychotic disorders. However, further research is required to determine the efficacy of specific models of treatment.
Publisher: Elsevier BV
Date: 05-2018
DOI: 10.1016/J.SCHRES.2017.08.037
Abstract: There is growing recognition of the relationship between trauma, posttraumatic stress disorder (PTSD) and psychosis. There may be overlaps in causal mechanisms involved in the development of PTSD and psychosis following traumatic or adverse events. Trauma-focussed treatments found to be effective in treating PTSD may therefore represent a new direction in the psychological treatment of psychosis. This systematic review examined the literature on trauma-focussed treatments conducted with people with schizophrenia spectrum or psychotic disorders to determine effects on psychotic symptoms. Secondary outcomes were symptoms of PTSD, depression and anxiety. Twenty-five studies were included in the review, with 12 being included in the meta-analysis. Trauma-focussed treatments had a small, significant effect (g=0.31, CI [0.55, 0.06]) on positive symptoms immediately post-treatment, but the significance and magnitude of this effect was not maintained at follow-up (g=0.18, CI [0.42, -0.06]). Trauma-focussed treatments also had a small effect on delusions at both post-treatment (g=0.37, CI [0.87, -0.12]) and follow-up (g=0.38, CI [0.67, 0.10]), but this only reached significance at follow-up. Effects on hallucinations and negative symptoms were small and non-significant. Effects on PTSD symptoms were also small (post-treatment g=0.21, CI [0.70, -0.27], follow up g=0.31, CI [0.62, 0.00]) and only met significance at follow-up. No significant effects were found on symptoms of depression and anxiety. Results show promising effects of trauma-focussed treatments for the positive symptoms of psychosis, however further studies developing and evaluating trauma-focussed treatments for trauma-related psychotic symptoms are needed.
Publisher: Cambridge University Press
Date: 31-12-2019
Publisher: Wiley
Date: 06-03-2013
Publisher: Wiley
Date: 06-03-2013
Publisher: Royal College of Psychiatrists
Date: 10-2021
DOI: 10.1192/BJP.2020.165
Abstract: Mindfulness-based therapies are increasingly available for a range of mental disorders, such as depression and anxiety. However, there remain concerns that mindfulness has the potential to exacerbate psychosis, despite a growing body of literature demonstrating effectiveness. These concerns may relate to long-standing perceptions about the suitability of offering psychological therapies to people with psychosis.
Publisher: Springer Science and Business Media LLC
Date: 24-05-2019
DOI: 10.1007/S00127-019-01731-9
Abstract: Loneliness is a challenge for in iduals with psychosis however, interventions rarely target loneliness in this group. We developed a pilot positive psychology group intervention designed to reduce loneliness in psychosis and examined its feasibility and acceptability. Sixteen participants attended 5.38 (SD = 0.70) out of six sessions, with a dropout rate of 10%. Participants were significantly less lonely at post-treatment (p < 0.001, d = 1.51), and maintained their improvements from post-treatment to follow-up (p = 0.81, d = 0.07). Loneliness may be a feasible and acceptable treatment target within psychosocial treatments.
Publisher: Springer Science and Business Media LLC
Date: 02-05-2018
Publisher: SAGE Publications
Date: 10-07-2016
Abstract: Inclusion in work and education remains problematic for many people with a mental illness. We describe a structured programme – the Health Optimisation Program for Employment – that supported people with a mental illness to gain employment or commence studies. Twenty hours of the Health Optimisation Program for Employment were delivered to 600 in iduals. Participants were asked to complete an evaluation survey encompassing vocational status and ratings of self-efficacy. Of the 364 participants who completed the baseline assessment, 168 responded to the evaluation survey 6 months after the delivery of the Health Optimisation Program for Employment. Of these, 21.5% had started a new job, while a further 42.8% were either volunteering or studying. Satisfaction with the programme was high and self-efficacy ratings improved significantly over the short term only. The Health Optimisation Program for Employment requires further evaluation using rigorous scientific methodology but these initial results are encouraging in terms of vocational attainment for people with a mental illness, in the Australian context.
Publisher: Oxford University Press (OUP)
Date: 23-12-0002
Publisher: Wiley
Date: 21-05-2202
DOI: 10.1111/PAPT.12284
Publisher: American Psychiatric Association Publishing
Date: 03-2017
Publisher: JMIR Publications Inc.
Date: 24-11-2020
Abstract: –Mental health resources are increasingly available for people who experience severe mental illness, including those who are users of community mental health services. However, the potential for service users (SUs) living with severe mental illness to use e–mental health resources together with their community mental health workers (MHWs) has received little attention. his study aims to identify how jointly using an interactive website called i Self-Management And Recovery Technology /i (SMART) in a community mental health context influenced therapeutic processes and interactions between SUs and MHWs from their perspective. e conducted a qualitative study using a constructivist grounded theory methodology. Data were collected through in idual semistructured interviews with 37 SUs and 15 MHWs who used the SMART website together for 2 to 6 months. Data analysis involved iterative phases of coding, constant comparison, memo writing, theoretical s ling, and consultation with stakeholders to support the study’s credibility. substantive grounded theory, i discovering ways to keep life on track /i , was developed, which portrays a shared discovery process arising from the SU-worker-SMART website interactions. The discovery process included choosing to use the website, revealing SUs’ experiences, exploring these experiences, and gaining new perspectives on how SUs did and could keep their lives on track. SUs and MHWs perceived that their three-way interactions were enjoyable, beneficial, and recovery focused when using the website together. They experienced the shared discovery process as relationship building—their interactions when using the website together were more engaging and equal. ointly using an e–mental health resource elicited recovery-oriented interactions and processes between SUs and MHWs that strengthened their therapeutic relationship in real-world community mental health services. Further work to develop and integrate this novel use of e–mental health in community mental health practice is warranted.
Publisher: Elsevier BV
Date: 02-2020
Publisher: Springer Science and Business Media LLC
Date: 20-06-2019
Publisher: JMIR Publications Inc.
Date: 25-04-2021
Abstract: uring the COVID-19 pandemic, we saw telehealth rapidly become the primary way to receive mental health care. International research has validated many of the benefits and challenges of telehealth known beforehand for specific population groups. However, if telehealth is to assume prominence in future mental health service delivery, greater understanding of its capacity to be used to provide psychosocial support to people with complex and enduring mental health conditions is needed. e focused on an Australian community-managed provider of psychosocial intervention and support. We aimed to understand service user and worker experiences of psychosocial support via telehealth throughout the COVID-19 pandemic. his study was jointly developed and conducted by people with lived experience of mental ill health or distress, mental health service providers, and university-based researchers. Semistructured interviews were conducted between August and November 2020 and explored participant experiences of receiving or providing psychosocial support via telehealth, including telephone, text, and videoconferencing. Qualitative data were analyzed thematically quantitative data were collated and analyzed using descriptive statistics. ervice users (n=20) and workers (n=8) completed in idual interviews via telephone or videoconferencing platform. Service users received psychosocial support services by telephone (12/20, 60%), by videoconferencing (6/20, 30%), and by both telephone and videoconferencing (2/20, 10%). Of note, 55% (11/20) of service user participants stated a future preference for in-person psychosocial support services, 30% (6/20) preferred to receive a mixture of in-person and telehealth, and 15% (3/20) elected telehealth only. Two meta-themes emerged as integral to worker and service user experience of telehealth during the pandemic: (1) creating safety and comfort and (2) a whole new way of working. The first meta-theme comprises subthemes relating to a sense of safety and comfort while using telehealth including trusting in the relationship and having and exercising choice and control. The second meta-theme contains subthemes reflecting key challenges and opportunities associated with the shift from in-person psychosocial support to telehealth. verall, our findings highlighted that most service users experienced telehealth positively, but this was dependent on them continuing to get the support they needed in a way that was safe and comfortable. While access difficulties of a subgroup of service users should not be ignored, most service users and workers were able to adapt to telehealth by focusing on maintaining the relationship and using choice and flexibility to maintain service delivery. Although most research participants expressed a preference for a return to in-person psychosocial support or hybrid in-person and telehealth models, there was a general recognition that intentional use of telehealth could contribute to flexible and responsive service delivery. Challenges to telehealth provision of psychosocial support identified in this study are yet to be fully understood.
Publisher: Elsevier BV
Date: 07-2020
Publisher: Elsevier BV
Date: 04-2012
Publisher: Elsevier BV
Date: 09-2016
DOI: 10.1016/J.PSYCHRES.2016.06.035
Abstract: Auditory verbal hallucinations (AVHs) are known to occur in mood disorders, but there has been scant research in the area. This paper aimed to explore the presence of hallucinations, and AVHs in particular, across affective disorders (with non-affective disorders serving as clinical reference groups). Specific attention was given to i) running commentary, ii) voices conversing, and iii) negative voices. A secondary aim was to examine patterns of associated delusional themes. Participants were 1550 Australians, aged 18-64 years, assigned to one of four groups on the basis of diagnosis: i) bipolar disorder (BD), ii) depressive psychosis (DP), iii) schizophrenia (SCZ), and iv) schizoaffective disorder (SAD). Relevant data collected from the 2010 Australian Survey of High Impact Psychosis (SHIP) was analysed. Current prevalence of hallucinations was such that BD<DP severity of hallucinations, and AVHs in particular, was in the order BD=DP<SAD=SCZ. These results were statistically significant. Negative voices, and concomitantly, persecutory delusions, were prominent across all clinical groups. Future research should examine age of AVH onset as well as other forms of AVHs, whilst taking into account participants' specific mood states.
Publisher: Elsevier BV
Date: 04-2012
Publisher: JMIR Publications Inc.
Date: 08-05-2018
DOI: 10.2196/MENTAL.9934
Abstract: Digital interventions offer an innovative way to make the experiences of people living with mental illness available to others. As part of the Self-Management And Recovery Technology (SMART) research program on the use of digital resources in mental health services, an interactive website was developed including videos of people with lived experience of mental illness discussing their recovery. These peer videos were designed to be watched on a tablet device with a mental health worker, or independently. Our aim was to explore how service users experienced viewing the lived experience videos on this interactive website, as well as its influence on their recovery journey. In total, 36 service users with experience of using the website participated in in idual semistructured qualitative interviews. All participants had experience of psychosis. Data analysis occurred alongside data collection, following principles of constructivist grounded theory methodology. According to participants, engaging with lived experience videos was a pivotal experience of using the website. Participants engaged with peers through choosing and watching the videos and reflecting on their own experience in discussions that opened up with a mental health worker. Benefits of seeing others talking about their experience included “being inspired,” “knowing I’m not alone,” and “believing recovery is possible.” Experiences of watching the videos were influenced by the participants’ intrapersonal context, particularly their ways of coping with life and use of technology. The interpersonal context of watching the videos with a worker, who guided website use and facilitated reflection, enriched the experience. Engaging with lived experience videos was powerful for participants, contributing to their feeling connected and hopeful. Making websites with lived experience video content available to service users and mental health workers demonstrates strong potential to support service users’ recovery.
Publisher: Elsevier BV
Date: 08-2020
Publisher: Elsevier BV
Date: 2018
Publisher: Wiley
Date: 23-02-2021
DOI: 10.1111/PAPT.12332
Abstract: The COVID‐19 pandemic has resulted in a widespread adoption of videoconferencing as a communication medium in mental health service delivery. This review considers the empirical literature to date on using videoconferencing to deliver psychological therapy to adults presenting with mental health problems. Papers were identified via search of relevant databases. Quantitative and qualitative data were extracted and synthesized on uptake, feasibility, outcomes, and participant and therapist experiences. Videoconferencing has an established evidence base in the delivery of cognitive behavioural therapies for post‐traumatic stress disorder and depression, with prolonged exposure, cognitive processing therapy, and behavioural activation non‐inferior to in‐person delivery. There are large trials reporting efficacy for health anxiety and bulimia nervosa compared with treatment‐as‐usual. Initial studies show applicability of cognitive behavioural therapies for other anxiety and eating disorders and obsessive–compulsive spectrum disorders, but there has yet to be study of use in severe and complex mental health problems. Therapists may find it more difficult to judge non‐verbal behaviour, and there may be initial discomfort while adapting to videoconferencing, but client ratings of the therapeutic alliance are similar to in‐person therapy, and videoconferencing may have advantages such as being less confronting. There may be useful opportunities for videoconferencing in embedding therapy delivery within the client’s own environment. Videoconferencing is an accessible and effective modality for therapy delivery. Future research needs to extend beyond testing whether videoconferencing can replicate in‐person therapy delivery to consider unique therapeutic affordances of the videoconferencing modality. Videoconferencing is an efficacious means of delivering behavioural and cognitive therapies to adults with mental health problems. Trial evidence has established it is no less efficacious than in‐person therapy for prolonged exposure, cognitive processing therapy, and behavioural activation. While therapists report nonverbal feedback being harder to judge, and clients can take time to adapt to videoconferencing, clients rate the therapeutic alliance and satisfaction similarly to therapy in‐person. Videoconferencing provides opportunities to integrate therapeutic exercises within the person’s day‐to‐day environment.
Start Date: 2014
End Date: 2017
Funder: National Health and Medical Research Council
View Funded ActivityStart Date: 2022
End Date: 2017
Funder: National Health and Medical Research Council
View Funded ActivityStart Date: 2008
End Date: End date not available
Funder: National Health and Medical Research Council
View Funded ActivityStart Date: 2016
End Date: 2019
Funder: National Health and Medical Research Council
View Funded ActivityStart Date: 2008
End Date: 2012
Funder: National Health and Medical Research Council
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