Mike (2016) Evaluation of a positive psychotherapy group intervention for people with psychosis: pilot randomised controlled trial. Epidemiology and Psychiatric Sciences, 25 (3). pp. 235-246. ISSN 2045-7979 Access from the University of Nottingham repository: http://eprints.nottingham.ac.uk/31606/1/AFD%20WELLFOCUS%20Pilot%20RCT%20trial %20report.pdf Copyright and reuse:The Nottingham ePrints service makes this work by researchers of the University of Nottingham available open access under the following conditions. This article is made available under the University of Nottingham End User licence and may be reused according to the conditions of the licence. For more details see: http://eprints.nottingham.ac.uk/end_user_agreement.pdf A note on versions:The version presented here may differ from the published version or from the version of record. If you wish to cite this item you are advised to consult the publisher's version. Please see the repository url above for details on accessing the published version and note that access may require a subscription. AbstractAims: Third-wave psychological interventions have gained relevance in mental health service provision but their application to people with psychosis is in its infancy and interventions targeting wellbeing in psychosis are scarce. This study tested the feasibility and preliminary effectiveness of positive psychotherapy adapted for people with psychosis (WELLFOCUS PPT) to improve wellbeing.Methods: WELLFOCUS PPT was tested as an 11-week group intervention in a convenience sample of people with psychosis in a single centre randomized controlled trial (ISRCTN04199273) involving 94 people with psychosis. Patients were individually randomized in blocks to receive either WELLFOCUS PPT in addition to treatment as usual (TAU), or TAU only. Assessments took place before randomisation and after the therapy.The primary outcome was wellbeing (Warwick-Edinburgh Mental Well-Being Scale).Secondary outcomes included symptoms (Brief Psychiatric Rating Scale), depression (Short Depression-Happiness Scale), self-esteem, empowerment, hope, sense of coherence, savoring beliefs, and functioning, as well as two alternative measures of wellbeing (the Positive Psychotherapy Inventory and Quality of Life). Intention-to-treat analysis was performed. This involved calculating crude changes and paired-sample t-tests for all variables, as well as ANCOVA and Complier Average Causal Effect Analysis to estimate the main effect of group on all outcomes. Results:The intervention and trial procedures proved feasible and well accepted. Crude changes between baseline and follow-up showed a significant improvement in the intervention group for wellbeing according to all three concepts assessed (i.e. WarwickEdinburgh Mental Well-Being Scale, Positive Psychotherapy Inventory, and Quality of Life), as well as for symptoms, depression, hope, self-esteem, and sense of coherence. No significant changes were observed in the control group. ANCOVA showed no main effect on wellbeing according to ...

Findings emphasize the importance of considering service users' perceptions of therapy and can be used to guide clinicians in deciding whether to include one or more of the components of WELLFOCUS PPT in therapy.

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Staff stated a recovery orientation in principle, but struggled to focus on service user strengths in practice. A stronger emphasis in clinical practice on amplifying strengths to foster self-management is indicated, and staff may need support to achieve this emphasis, e.g. through specific interventions and involvement of peer support workers.

Twenty-three people with psychosis were interviewed about their subjective experience of 'forgiveness'. Resulting themes of enabling conditions, thinking styles, psychological and interpersonal benefits, and need for caution may inform clinical practice on trauma, adverse life events, and relationships in psychosis.