A randomized controlled feasibility trial of online compassion‐focused self‐help for psoriasis*

Abstract

Summary Background People with psoriasis can experience psychological distress that might be amenable to psychosocial self‐help. Objectives This study tested the feasibility and acceptability of two theoretically developed self‐help interventions designed to reduce feelings of shame and improve quality of life. Methods A randomized controlled feasibility trial was conducted comprising 130 participants with psoriasis who were randomly allocated to receive either compassion‐based self‐help (n = 65) or mindfulness‐based self‐help (n = 65), over a 4‐week period. Both interventions were provided online. Results The interventions were found to be acceptable, with over 70% of study completers reporting that they found the materials helpful. Of the 130 participants, 92 completed the study, with attrition at 29%. Both interventions showed modest yet statistically significant reductions in shame (Cohen’s d = 0.20) and improvements in quality of life (Cohen’s d = 0.40). Conclusions Self‐help based on compassion and mindfulness is acceptable to users, and can reduce feelings of shame and improve quality of life for people living with psoriasis. What is already known about this topic? Psoriasis can be associated with psychological distress. Various forms of psychological intervention have been tested; however, few compassion based interventions have been developed or trialled. What does this study add? This study demonstrates that compassion‐based self‐help is acceptable to people with psoriasis. This study provides provisional evidence of effectiveness of compassion based self‐help in reducing feelings of shame and improving quality of life for people living with psoriasis.

Does Guided Written Disclosure Reduce Distress and Improve Psychological Functioning in Patients with Skin Diseases?

“…For example, a mindfulness-based cognitive therapy group therapy was effective in improving quality of life in patients with psoriasis [ 46 ]. Moreover, compassion-based and mindfulness-based self-help were found to be acceptable in people with psoriasis, and both interventions showed reductions in shame and improvements in quality of life [ 47 ]. A compassion-focused self-help has also shown promise in reducing perceived stress, anxiety, depression and impairment of quality of life, as well in improving self-compassion, in patients with skin conditions [ 48 ].…”

Should self‐help interventions become routine in psoriasis therapy?

“…Reinforcing these observations, Muftin et al 4 . examined the impact of online compassion‐focused self‐help for psoriasis, and report their findings in this issue of the BJD .…”

“…Self‐help intervention can be considered a first‐step approach for individuals with mild levels of distress, motivating patients to seek further psychological interventions, as necessary 4 . Although their potential has not been exploited, this kind of intervention could become a first‐line approach, with added cost‐effectiveness benefit 4 .…”

“…Self‐help intervention can be considered a first‐step approach for individuals with mild levels of distress, motivating patients to seek further psychological interventions, as necessary 4 . Although their potential has not been exploited, this kind of intervention could become a first‐line approach, with added cost‐effectiveness benefit 4 . Beyond the statistical analysis of management approaches, the inner personality strengthening flowing from some psychological interventions is a subtle, continuous process that is hard to measure, but which sometimes has a real impact on a patient’s life.…”

How does self-compassion help people adjust to chronic skin conditions? A template analysis study

“…Psychological flexibility, the ability to consciously engage with the present moment in a way that is consistent with one's values, has been linked with lower appearance anxiety in people with burn injuries ( 8 ), and mindfulness and self-compassion have both been linked with lower psychological distress in dermatology patients ( 9 , 10 ). Furthermore, there is preliminary evidence that mindfulness and compassion-based interventions can reduce shame and depression in people with skin conditions ( 11 , 12 ). These studies indicate that positive psychological factors show promise as therapeutic targets to promote adjustment to skin conditions but further research is needed to explore how they might promote adjustment.…”