Hostname: page-component-76fb5796d-45l2p Total loading time: 0 Render date: 2024-04-26T15:18:49.151Z Has data issue: false hasContentIssue false
  • English
  • Français

Impact of a brief worry-based cognitive therapy group in psychosis: a study of feasibility and acceptability

Published online by Cambridge University Press:  29 April 2019

Helen Courtney ,
Lucy White ,
Thomas Richardson ,
Ben Dasyam ,
Jo Tedbury  and
Jane Butt
Helen Courtney
Affiliation:
Mental Health Recovery Teams, Solent NHS Trust, St Mary’s Community Health Campus, Milton Road, Portsmouth PO3 6AD, UK
Lucy White
Affiliation:
Mental Health Recovery Teams, Solent NHS Trust, St Mary’s Community Health Campus, Milton Road, Portsmouth PO3 6AD, UK
Thomas Richardson*
Affiliation:
Mental Health Recovery Teams, Solent NHS Trust, St Mary’s Community Health Campus, Milton Road, Portsmouth PO3 6AD, UK
Ben Dasyam
Affiliation:
Mental Health Recovery Teams, Solent NHS Trust, St Mary’s Community Health Campus, Milton Road, Portsmouth PO3 6AD, UK
Jo Tedbury
Affiliation:
Mental Health Recovery Teams, Solent NHS Trust, St Mary’s Community Health Campus, Milton Road, Portsmouth PO3 6AD, UK
Jane Butt
Affiliation:
Mental Health Recovery Teams, Solent NHS Trust, St Mary’s Community Health Campus, Milton Road, Portsmouth PO3 6AD, UK
*
*Corresponding author. Email: Thomas.Richardson@Solent.nhs.uk
Get access Rights & Permissions [Opens in a new window]

Abstract

Previous research suggests that CBT focusing on worry in those with persecutory delusions reduces paranoia, severity of delusions and associated distress. This preliminary case series aimed to see whether it is feasible and acceptable to deliver worry-focused CBT in a group setting to those with psychosis. A secondary aim was to examine possible clinical changes. Two groups totalling 11 participants were run for seven sessions using the Worry Intervention Trial manual. Qualitative and quantitative data about the experience of being in the group was also collected via questionnaires, as was data on number of sessions attended. Measures were delivered pre- and post-group and at 3-month follow-up. These included a worry scale, a measure of delusional belief and associated distress and quality of life measures. Of the 11 participants who started the group, nine completed the group. Qualitative and quantitative feedback indicated that most of the participants found it acceptable and helpful, and that discussing these issues in a group setting was not only tolerable but often beneficial. Reliable Change Index indicated that 6/7 of the group members showed reliable reductions in their levels of worry post-group and 5/7 at follow-up. There were positive changes on other measures, which appeared to be more pronounced at follow-up. Delivering a worry intervention in a group format appears to be acceptable and feasible. Further research with a larger sample and control group is indicated to test the clinical effectiveness of this intervention.

Key learning aims

  1. (1) To understand the role of worry in psychosis.

  2. (2) To learn about the possible feasibility of working on worry in a group setting.

  3. (3) To be aware of potential clinical changes from the group.

  4. (4) To consider acceptability for participants of working on worries in a group setting.

Keywords

CBTgroupparanoiapersecutory delusionspsychosisworry
Type
Original Research
Information
the Cognitive Behaviour Therapist , Volume 12 , 2019 , e29
Copyright
© British Association for Behavioural and Cognitive Psychotherapies 2019 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Further reading

Freeman, D (2016). Persecutory delusions: a cognitive perctive on understanding and treatment. The Lancet Psychiatry 3, 685–692.CrossRefGoogle ScholarPubMed
Freeman, D, Dunn, G, Startup, H, Pugh, K, Cordwell, J, Mander, H, Cernis, E, Wingham, G, Shirvell, K, & Kingdon, D (2015). Effects of cognitive behaviour therapy for worry on persecutory delusions in patients with psychosis (WIT): a parallel, single-blind, randomised controlled trial with a mediation analysis. Lancet Psychiatry 2, 305–313.CrossRefGoogle ScholarPubMed
Isham, L, Grafahrend, H, Nickless, A, Pugh, K, Pleasants, S, Smedley, N, Freeman, D, & Mulligan, A (2018). Group-based worry intevention for persecutory delusions: an initial feasibility study. Behavioural and Cognitive Psychotherapy 46, 619–625.CrossRefGoogle Scholar

References

de Souza Costa, D, & De Paula, JJ (2015). Usefulness of the reliable change index for psychology and psychiatry in clinical practice: a case report of cognitive-behavioral therapy. Clinical Neuropsychiatry 12, 135–138.Google Scholar
Freeman, D (2013). Cognitive-behavioral therapy for psychotic disorders. Psychiatric Times 30, 16.Google Scholar
Freeman, D (2016). Persecutory delusions: a cognitive perctive on understanding and treatment. The Lancet Psychiatry 3, 685–692.CrossRefGoogle ScholarPubMed
Freeman, D, Dunn, G, Startup, H, Pugh, K, Cordwell, J, Mander, H, Cernis, E, Wingham, G, Shirvell, K, & Kingdon, D (2015). Effects of cognitive behaviour therapy for worry on persecutory delusions in patients with psychosis (WIT): a parallel, single-blind, randomised controlled trial with a mediation analysis. Lancet Psychiatry 2, 305–313.CrossRefGoogle ScholarPubMed
Freeman, D, Stahl, D, McManus, S, Meltzer, H, Brugha, T, Wiles, N, & Bebbington, P (2012). Insomnia, worry, anxiety and depression as predictors of the occurrence and persistence of paranoid thinking. Social Psychiatry and Psychiatric Epidemiology 47, 1195–1203.CrossRefGoogle ScholarPubMed
Fresco, DM, Mennin, DS, Heimberg, RG, & Turk, CL (2003). Using the Penn State Worry Questionnaire to identify individuals with generalized anxiety disorder: a receiver operating characteristic analysis. Journal of Behavior Therapy and Experimental Psychiatry 34, 283–291.CrossRefGoogle ScholarPubMed
Green, CEL, Freeman, D, Kuipers, E, & Bebbington, P (2008). Measuring ideas of persecution and social reference: the Green et al. Paranoid Thought Scales (GPTS). Psychological Medicine 38, 101–111.CrossRefGoogle Scholar
Greenwood, KE, Sweeney, A, Williams, S, Garety, P, Kuipers, E, Scott, J, & Peters, E (2010).CHoice of Outcome In Cbt for psychosEs (CHOICE): The development of a new service user-led outcome measure of CBT for psychosis. Schizophrenia Bulletin 36, 126–135.CrossRefGoogle ScholarPubMed
Haddock, G, McCarron, J, Tarrier, N, Faragher, E, & Tarrier, N (1999). Scales to measure dimensions of hallucinations and delusions: the psychotic symptom rating scales (PSYRATS). Psychological Medicine 29, 879–889.CrossRefGoogle Scholar
Isham, L, Grafahrend, H, Nickless, A, Pugh, K, Pleasants, S, Smedley, N, Freeman, D, & Mulligan, A (2018). Group-based worry intevention for persecutory delusions: an initial feasibility study. Behavioural and Cognitive Psychotherapy 46, 619–625.CrossRefGoogle Scholar
Jacobson, NS, & Truax, P (1991). Clinical significance: a statistical approach to defining meaningful change in psychotherapy research. Journal of Consulting and Clinical Psychology 59, 12–19.CrossRefGoogle ScholarPubMed
Keetharuth, D, Brazier, J, Connell, J, Bjorner, J, Carlton, J, Taylor Buch, E, Rickets, T, McKendrick, K, Browne, J, Croudace, T, & Barkham, M (2018). Recovering Quality of Life (ReQoL): a new generic self-reported outcome measure for use with people experiencing mental health difficulties. British Journal of Psychiatry 212, 42–49.CrossRefGoogle ScholarPubMed
Meyer, TJ, Miller, ML, Metzger, RL, & Borkovec, TD (1990). Development and validation of the Penn State Worry Questionnaire. Behaviour Research and Therapy 28, 487–496.CrossRefGoogle ScholarPubMed
Morrison, AP (2001) The interpretation of intrusions in psychosis: an integrative cognitive approach to hallucinations and delusions. Behavioural and Cognitive Psychotherapy 29, 257–276.CrossRefGoogle Scholar
Mundt, JC, Marks, IM, Shear, MK, & Greist, JM (2002). The work and social adjustment scale: a simple measure of impairment in functioning. British Journal of Psychiatry 180, 461–464.CrossRefGoogle ScholarPubMed
National Institute for Health and Care Excellence (NICE) (2014) Psychosis and schizophrenia in adults: prevention and management. NICE Guideline (CG178).Google Scholar
Ruddle, A, Mason, O, & Wykes, T (2011). A review of hearing voices groups: evidence and mechanisms of change. Clinical Psychology Review 31, 757–766.CrossRefGoogle ScholarPubMed
Startup, H, Freeman, D, & Garety, PA (2007). Persecutory delusions and catastrophic worry in psychosis: developing the understanding of delusion distress and persistence. Behaviour Research and Therapy 45, 523–537.CrossRefGoogle ScholarPubMed
Zahra, D, & Hedge, C (2010). The Reliable Change Index: why isn’t it more popular in academic psychology? British Psychological Society Psychology Postgraduate Affairs Group Quarterly 76, 14–19.Google Scholar
Submit a response

Comments

No Comments have been published for this article.