Randomised controlled trial of a digitally assisted low intensity intervention to promote personal recovery in persisting psychosis: SMART-Therapy study protocol

Abstract

BackgroundPsychosocial interventions have an important role in promoting recovery in people with persisting psychotic disorders such as schizophrenia. Readily available, digital technology provides a means of developing therapeutic resources for use together by practitioners and mental health service users. As part of the Self-Management and Recovery Technology (SMART) research program, we have developed an online resource providing materials on illness self-management and personal recovery based on the Connectedness-Hope-Identity-Meaning-Empowerment (CHIME) framework. Content is communicated using videos featuring persons with lived experience of psychosis discussing how they have navigated issues in their own recovery. This was developed to be suitable for use on a tablet computer during sessions with a mental health worker to promote discussion about recovery.Methods/DesignThis is a rater-blinded randomised controlled trial comparing a low intensity recovery intervention of eight one-to-one face-to-face sessions with a mental health worker using the SMART website alongside routine care, versus an eight-session comparison condition, befriending. The recruitment target is 148 participants with a schizophrenia-related disorder or mood disorder with a history of psychosis, recruited from mental health services in Victoria, Australia. Following baseline assessment, participants are randomised to intervention, and complete follow up assessments at 3, 6 and 9 months post-baseline. The primary outcome is personal recovery measured using the Process of Recovery Questionnaire (QPR). Secondary outcomes include positive and negative symptoms assessed with the Positive and Negative Syndrome Scale, subjective experiences of psychosis, emotional symptoms, quality of life and resource use. Mechanisms of change via effects on self-stigma and self-efficacy will be examined.DiscussionThis protocol describes a novel intervention which tests new therapeutic methods including in-session tablet computer use and video-based peer modelling. It also informs a possible low intensity intervention model potentially viable for delivery across the mental health workforce.Trial registrationNCT02474524, 24 May 2015, retrospectively registered during the recruitment phase.

Promoting Personal Recovery in People with Persisting Psychotic Disorders: Development and Pilot Study of a Novel Digital Intervention

“…The estimated effect size on recovery is similar to effects observed for other psychosocial interventions for persisting psychosis (48). Together, these findings suggest value in conducting a larger-scale controlled trial of this intervention (49). …”

Recovery After Psychosis: Qualitative Study of Service User Experiences of Lived Experience Videos on a Recovery-Oriented Website (Preprint)

“…This study explored consumers' experiences of using an innovative and interactive recovery-oriented website, SMART [27,28]. Overall the findings show that using the SMART website was viewed as positively supporting participants in their personal recovery journeys.…”

“…The website also Participants used the SMART website in one of two ways. Of the 36 participants in this study, twenty-six SMART-Therapy [28] participants met individually with a mental health worker trained to deliver a focused intervention using the interactive website. Eight, 50 minute-long meetings using SMART were held over 2-3 months in the mental health service or participants' homes.…”

“…As part of an overall research program [28], qualitative research explored how consumers and workers experienced using these website resources. This paper focuses on consumers' experiences of the peer videos on the website, and how these experiences have influenced their recovery journey.…”

Internet- und mobilbasierte Interventionen bei Schizophrenie

“…Eine Pilotstudie ohne Vergleichsbedingung mit 9 Teilnehmenden mit Schizophrenie [Depp et al, 2010] konnte die prinzipielle Machbarkeit von Blended Treatment bei dieser Patientengruppe aufzeigen. Einem publizierten Studienprotokoll zufolge wird in diesem Bereich aktuell intensiv geforscht [Thomas et al, 2016]. Die Vorteile von klassischen und Internet-basierten Behandlungen könnten so vereint werden.…”