Treating first episode psychosis – the service users’ perspective: a focus group evaluation

Abstract

UK national guidance has prioritized developing specialist services for first episode psychosis. Such services are in the early stages of development and a definitive treatment model has yet to be established. The aim of this study was to explore service users' experiences of a first episode intervention designed along evidence-based 'best practice' guidelines and to establish specific elements seen as effective to help inform future service planning and provision. Twelve users of a specialist first episode service participated in focus groups. These were then analyzed using Interpretative Phenomenological Analysis, a specialized form of content analysis. Key elements identified by the service users included the 'human' approach as a key to the recovery process, being involved in treatment decisions, flexibility of appointments, high nurse to patient ratio, reduction in psychotic symptoms, increased confidence and independence and the provision of daily structure. To our knowledge, this is the first systematic qualitative evaluation of users' experience of a specialist first episode treatment intervention. Our findings indicate that adherence to best practice guidelines was appreciated. Regular focus groups provide a continuous audit cycle incorporating service improvements in line with government recommendations, centrally informed by the service users' and caregivers' perspective.

Service‐users’ experiences of an early intervention in psychosis service: An interpretative phenomenological analysis

“…Previous research has noted a tendency for participants to talk specifically about their Care co-ordinators when referring to EIP services (O"Toole et al, 2004) and has suggested the influence of EIP staff views and professional backgrounds on the explanation of psychosis offered to clients (Larsen, 2007). However, the current research also suggested support offered by the EIP service had potential limits and was unable to resolve all the complex layers of the participants" ongoing journeys.…”

“…The research has provided an insight in to the aspects of an EIP service which were appreciated by service-users (O"Toole et al, 2004) and provided insights into the socio-cultural workings of an intervention (Larsen, 2007). However, limitations including the use of focus group methods, self selected samples, service-users from an experimental EIP context, and inevitable differences between EIP models delivered in different countries (Larsen, 2007).…”

“…O" Toole et al (2004) conducted a focus group evaluation of service-users" experiences of a UK specialist intervention for FEP. Positive views included the "human" approach, involvement in decision making and positive impact on confidence.…”

Structural neuroimaging in psychosis: a systematic review and economic evaluation

“…52 From a service user's perspective, being an NHS inpatient has been described as "horrible, scary, surviving the system, institutionalised, feeling strange, labelled, used in experiments, no choice". 53 Patients in this study valued one-to-one contact and personal relationships with carers, active involvement in care, choice and the feeling that their opinions mattered.…”

Reviews: Emerging Empirical Evidence on the Ethics of Schizophrenia Research

“…Empirical work examining the perspectives of firstepisode individuals and their families, 93 the risks for noncompliance, and understanding of potential risks and benefits is now being conducted, while others have begun to apply the MacCAT model to capacity assessments among prodromal and first-episode subjects. [98][99][100][101] Currently, some of the most rapid progress in psychiatric research comes from studies that examine genetic vulnerability, interactions of genetic and environmental factors on disease expression, the role of endophenotypes, and genetic and genomic determinants of treatment response. [102][103][104][105][106][107][108][109][110] However, the ethical considerations of these genetic studies have seldom been evaluated using empirical ethics methods.…”