The study describes the positive and negative experiences of service users with BPD attending an adapted DBT programme.

Little is known of the usability of Eye Movement Desensitization and Reprocessing (EMDR) as an intervention for those experiencing psychosis. This study aimed to explore therapists’ experience of using EMDR with this population. A qualitative design was employed using an inductive approach and a thematic analysis. Twenty therapists, who had used EMDR with this client group, took part in a semi-structured interview to explore their experiences of the intervention. Key themes were generated from the data: (a) Familiarity with psychosis and EMDR, (b) Acceptability of EMDR, (c) The importance of systemic factors, and (d) Keeping key therapy principles in mind. Findings highlighted the importance of supervision to build therapist confidence, the value of the multidisciplinary team and the need for a shift in beliefs surrounding the usefulness of EMDR to the wider system. Recommendations for individuals and services are provided.

Background: Current psychological interventions for psychosis focus primarily on cognitive and behavioural management of delusions and hallucinations, with modest outcomes. Emotions are not usually targeted directly, despite evidence that people with psychosis have difficulty identifying, accepting and modifying affective states. Aims: This study assessed the impact of emotion regulation skills practice on affect and paranoia in seven people who met criteria for a diagnosis of schizophrenia or schizoaffective disorder. Method: The study utilised a single case ABA design and measured emotion regulation skills, affect and paranoia over baseline, intervention and withdrawal of intervention phases. We predicted that eight sessions of skills rehearsal would lead to improved emotion regulation, reduced negative affect, increased positive affect, and reduced paranoia. Results: Most participants were able to learn to regulate their emotions, and reported reduced negative affect and paranoia. There was no clear pattern of change for positive affect. Conclusions: These findings suggest that emotion can be targeted in psychosis, and is associated with reduced paranoia. Emotion regulation may constitute a key treatment target in cognitive behavioural therapy for psychosis.

Background:Paranoia is often accompanied by distressing intrusions associated with traumatic memories, yet one of the best-evidenced interventions, imagery rescripting (IR), is not routinely offered. This is likely to be due to poor understanding of the effects of IR on postulated mechanisms of change as well as the absence of a robust evidence base.Aims:This study aimed to establish proof of principle that IR impacts key cognitive-affective processes associated with distressing intrusions – memory characteristics and self-representations – and level of paranoia.Method:We used a within-subject repeated measures design to examine the effect of single-session IR on memory characteristics (level of intrusions, vividness, distress, encapsulated belief strength, emotion intensity and frequency), self-representation variables, affect and paranoia. Fifteen participants were seen once before and once after the IR session, to gather baseline and follow-up data.Results:As predicted, participants reported reductions in memory characteristics, improved self-esteem and positive affect, and reduced negative affect and paranoia, with large effect sizes. These effects were maintained at follow-up.Conclusions:While a within-subject design is useful for initial exploration of novel interventions, controlled studies are needed to determine causality. This is the first study to examine mechanisms of IR in paranoia. A controlled trial is now warranted.

Most research evaluating eye movement desensitization and reprocessing (EMDR) therapy has taken place in community settings, leaving the impact for service users within inpatient environments less clear. This systematic review sought to identify, summarize, and critically evaluate studies that investigated the impact of EMDR on symptoms of posttraumatic stress disorder (PTSD) within adult inpatient mental health settings. Seven databases were systematically searched to identify published and unpublished articles eligible for inclusion. Eleven studies, published between 1995 and 2020, were included within this review. All studies showed that EMDR improved PTSD symptoms, across a variety of study populations. However, these findings are limited by the (a) preponderance of case study designs (preventing causal attribution); (b) provision of synchronous treatments; (c) poor methodological quality; and (d) high heterogeneity across studies. Prior research has shown EMDR’s effectiveness and safety for vulnerable populations. While the evidence is beginning to support its use with those experiencing PTSD symptoms within adult inpatient settings, it is premature to strongly recommend it as a routine intervention. Future research within this area is recommended.