CBT to Address and Prevent Social Disability in Early and Emerging Psychosis

Fowler, David; French, Paul; Hodgekins, Joanne; Lower, Rebecca; Turner, Ruth; Burton, Simon C.; Wilson, Jonathan

doi:10.1002/9781118330029.ch8

Cited by 19 publications

(24 citation statements)

References 19 publications

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“…SRT is described in a therapy manual [49]. SRT is delivered individually in face-to-face sessions (Median = 15 sessions) across 9 months and may involve interim telephone and email contact.…”

Section: Methodsmentioning

confidence: 99%

Prevention and treatment of long-term social disability amongst young people with emerging severe mental illness with social recovery therapy (The PRODIGY Trial): study protocol for a randomised controlled trial

Fowler

French

Banerjee

et al. 2017

Trials

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BackgroundYoung people who have social disability associated with severe and complex mental health problems are an important group in need of early intervention. Their problems often date back to childhood and become chronic at an early age. Without intervention, the long-term prognosis is often poor and the economic costs very large. There is a major gap in the provision of evidence-based interventions for this group, and therefore new approaches to detection and intervention are needed. This trial provides a definitive evaluation of a new approach to early intervention with young people with social disability and severe and complex mental health problems using social recovery therapy (SRT) over a period of 9 months to improve mental health and social recovery outcomes.MethodsThis is a pragmatic, multi-centre, single blind, superiority randomised controlled trial. It is conducted in three sites in the UK: Sussex, Manchester and East Anglia. Participants are aged 16 to 25 and have both persistent and severe social disability (defined as engaged in less than 30 hours per week of structured activity) and severe and complex mental health problems. The target sample size is 270 participants, providing 135 participants in each trial arm. Participants are randomised 1:1 using a web-based randomisation system and allocated to either SRT plus optimised treatment as usual (enhanced standard care) or enhanced standard care alone. The primary outcome is time use, namely hours spent in structured activity per week at 15 months post-randomisation. Secondary outcomes assess typical mental health problems of the group, including subthreshold psychotic symptoms, negative symptoms, depression and anxiety. Time use, secondary outcomes and health economic measures are assessed at 9, 15 and 24 months post-randomisation.DiscussionThis definitive trial will be the first to evaluate a novel psychological treatment for social disability and mental health problems in young people presenting with social disability and severe and complex non-psychotic mental health problems. The results will have important implications for policy and practice in the detection and early intervention for this group in mental health services.Trial registrationTrial Registry: International Standard Randomised Controlled Trial Number (ISRCTN) Registry.Trial Registration Number: ISRCTN47998710 (registered 29/11/2012).Electronic supplementary materialThe online version of this article (doi:10.1186/s13063-017-2062-9) contains supplementary material, which is available to authorized users.

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Section: Methodsmentioning

confidence: 99%

Prevention and treatment of long-term social disability amongst young people with emerging severe mental illness with social recovery therapy (The PRODIGY Trial): study protocol for a randomised controlled trial

Fowler

French

Banerjee

et al. 2017

Trials

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“…Furthermore, this study empirically supports the importance of hopefulness 368 to social inclusion and vocational activity and current findings reinforce the emerging 369 greater therapeutic focus on raising young service users' hopefulness and positive self-370 beliefs in CBT in psychosis (Nelson et al, 2009;Fowler et al, 2013;Freeman et al, 371 2014;Hodgekins & Fowler, 2010 Running head: Self-beliefs, social inclusion & psychosis 30 Table 3. Mediation models of the associations between self-stigma and outcome (social activity, community belonging and vocational activity) through hopefulness.…”

Section: Discussion 308mentioning

confidence: 72%

Direct and indirect associations between dysfunctional attitudes, self-stigma, hopefulness and social inclusion in young people experiencing psychosis

Berry

Greenwood

2018

Schizophrenia Research

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3Objective: Social inclusion and vocational activity are central to personal 4 recovery for young people with psychosis. Studies with people experiencing long 5 term psychosis suggest negative self-beliefs are important, but less is known about 6 whether this association is present for young service users or about the potential 7 influence of positive self-beliefs such as hopefulness. The aim of the current paper 8 was to investigate the direct and indirect associations between dysfunctional 9 attitudes, self-stigma, hopefulness, social inclusion and vocational activity for 10 young people with psychosis.

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“…However, there are limited studies focusing on interventions for functional outcomes, despite research evidence that such outcomes are poor in this client group (Hodgekins et al, 2015). Fowler et al (2013) propose a specific therapeutic intervention called social recovery therapy (SRT) which incorporates CBT techniques with case management and employment support in order to improve functional outcomes following psychosis. Social recovery can be defined in terms of engagement in activities within occupational and interpersonal domains (Hodgekins et al, 2015).…”

Section: Social Recovery Therapymentioning

confidence: 99%

“…Table 1 provides a list of the components and their description. The checklist was developed by the authors and corresponded to the key components of the therapy as detailed in the therapy manual (Fowler et al, 2013).…”

Section: The Adherence Checklistmentioning

confidence: 99%

Measuring adherence in social recovery therapy with people with first episode psychosis

Lowen

Hodgekins

Pugh

et al. 2019

Behav. Cogn. Psychother.

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Background:The SUPEREDEN3 study, a phase II randomized controlled trial, suggests that social recovery therapy (SRT) is useful in improving functional outcomes in people with first episode psychosis. SRT incorporates cognitive behavioural therapy (CBT) techniques with case management and employment support, and therefore has a different emphasis to traditional CBT for psychosis, requiring a new adherence tool.Aims:This paper describes the SRT adherence checklist and content of the therapy delivered in the SUPEREDEN3 trial, outlining the frequency of SRT techniques and proportion of participants who received a full therapy dose. It was hypothesized that behavioural techniques would be used frequently, consistent with the behavioural emphasis of SRT.Method:Research therapists completed an adherence checklist after each therapy session, endorsing elements of SRT present. Data from 1236 therapy sessions were reviewed to determine whether participants received full, partial or no therapy dose.Results:Of the 75 participants randomized to receive SRT, 57.3% received a full dose, 24% a partial dose, and 18.7% received no dose. Behavioural techniques were endorsed in 50.5% of sessions, with cognitive techniques endorsed in 34.9% of sessions.Conclusions:This report describes an adherence checklist which should be used when delivering SRT in both research and clinical practice. As hypothesized, behavioural techniques were a prominent feature of the SRT delivered in SUPEREDEN3, consistent with the behavioural emphasis of the approach. The use of this adherence tool would be considered essential for anyone delivering SRT looking to ensure adherence to the model.

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CBT to Address and Prevent Social Disability in Early and Emerging Psychosis

Cited by 19 publications

References 19 publications

Prevention and treatment of long-term social disability amongst young people with emerging severe mental illness with social recovery therapy (The PRODIGY Trial): study protocol for a randomised controlled trial

Prevention and treatment of long-term social disability amongst young people with emerging severe mental illness with social recovery therapy (The PRODIGY Trial): study protocol for a randomised controlled trial

Direct and indirect associations between dysfunctional attitudes, self-stigma, hopefulness and social inclusion in young people experiencing psychosis

Measuring adherence in social recovery therapy with people with first episode psychosis

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