Symposium II: New Developments in Understanding and Treating Specific Targets within Cognitive -Behavioural Approaches to Psychosis
Rowan Diamond
David van den Berg
Filippo Varese
Title: A framework for understanding movement and physical activity in patients diagnosed with psychosis
Background: Patients diagnosed with psychosis often spend less time than others engaged in exercise and more time sitting down, which contributes to poorer physical and mental health.
Methods Interviews and focus groups were conducted with patients, carers and staff. Data were analysed using reflexive thematic analysis.
Findings: 19 patients, 14 carers and 18 staff participated in the study. Five factors were found to promote movement and physical activity. These were i) Purpose: a purpose to the movement ii) Predictions: an expectation of the positive consequences of movement iii) Present state: a state of readiness physically and emotionally iv) Provision: the availability of effective and tailored support v) Process: helpful or unhelpful cycles that affect movement.
Conclusions and Clinical Implications: The 5 P (Purpose, Predictions, Present state, Provision and Process) framework for understanding movement and physical activity has the potential to inform future research and guide interventions. A checklist is presented for clinicians to help foster change in activity levels.
Title: Effects of Trauma-focused Therapy on Voice Hearing in Daily Life
Abstract: We investigated the effect of trauma-focused therapy (TFT) on voice-hearing severity in people with PTSD and psychosis using experience sampling method (ESM). The currents study is an adjunct longitudinal ESM study of a sub-group of participants (N=39) from a randomised controlled trial that compared TFT to a waiting-list control group. The Multilevel linear regression intention-to-treat analysis showed a larger decrease in voice-hearing severity in the TFT group than in the waiting-list control group. Also, a significant association was observed between change in PTSD symptoms and change in voice-hearing severity. These findings tentatively suggest that, even when voices are not targeted directly, TFT for PTSD can have a positive effect on severity of voice-hearing.
Title: Trauma and Attenuated Symptoms of Psychosis
Abstract: Trauma is a known risk factor for psychosis. While considerable innovation is taking place in the evaluation of trauma-focused therapies in people with psychosis, applications to the prevention of psychosis are lagging behind. In this talk, Filippo will illustrate findings on the association between childhood trauma exposure and prodromal symptoms of psychosis in the IPPACT cohort (one of the largest longitudinal cohort study of UHR/ARMS individuals), and the role played by more nuanced emotional and psychological consequences in the maintenance of attenuates / at risk symptoms in 75 participants recruited for the RESTART (REducing the risk for psychosiS by TARgeting Trauma) trial.
Shirley Glynn & Felice Reddy
Title: A Novel Combination of Motivational Interviewing and Cognitive Behavioral Therapy to Improve Motivation and Functioning in Schizophrenia
Abstract: The Motivational Interviewing and Cognitive Behavior Therapy (MI-CBT) intervention focuses on improving motivation and achieving of personally meaningful goals. In the original RCT, we found meaningful and lasting improvements in motivational negative symptoms. To optimize engagement and accessibility of the treatment for clients in diverse settings, we have expanded the protocol to be applied in a variety of settings, with diverse providers, and a range of clinical diagnoses characterized by motivation deficits. In our subsequent study, we found significant improvements in motivational negative symptoms, quality of life, and community functioning in recently housed Veterans. The results show that MI- CBT yields improvements in negative symptoms, generally thought of as resistant to intervention. Importantly, our results suggest the intervention can be adapted and disseminated, thereby increasing equity and access to care.