Hostname: page-component-586b7cd67f-2plfb Total loading time: 0 Render date: 2024-11-28T02:31:39.095Z Has data issue: false hasContentIssue false

A qualitative systematic review of Early Intervention in Psychosis service user perspectives regarding valued aspects of treatment with a focus on cognitive behavioural therapy

Published online by Cambridge University Press:  28 October 2021

Lauren Cox*
Affiliation:
Halton & Warrington Early Intervention in Psychosis Team, Merseycare NHS Foundation Trust, Liverpool, UK
Colette Miller
Affiliation:
Faculty of Health and Care, University of Central Lancashire, Preston, UK
*
*Corresponding author. Email: [email protected]

Abstract

Background:

Despite the increasing evidence base and focus given to Early Intervention in Psychosis (EIP) services, qualitative literature remains sparse, particularly in relation to the ‘At Risk Mental State’ (ARMS) group. Although research has looked to service user experience within EIP, data have not been collated to understand valued aspects of treatment across both EIP groups: first episode psychosis (FEP) and ARMS, particularly regarding cognitive behavioural therapy (CBT).

Aims:

To conduct a systematic review of qualitative literature to examine service user perspectives on support provided in EIP treatment with a focus on CBT.

Method:

This was a thematic synthesis of qualitative studies. Nine studies were included in the analysis identified through a systematic database search and citation tracking. Studies were critically appraised using the critical appraisal skills programme tool.

Results:

Nine studies were identified for inclusion. Six analytical themes and 20 descriptive categories were identified.

Conclusions:

User perspectives confirm previous findings highlighting importance of therapeutic relationships for treatment success. Normalisation, learning and understanding were valued across both groups, which increased coping, and can be facilitated throughout the EIP journey. Harnessing the support of those involved in users’ care and understanding these relationships further enhances interventions utilised. Understanding the stage the individual is at regarding their experiences is essential in relation to targeting support. Transdiagnostic aspects of CBT were valued across both groups. ARMS referred to more specific strategies and there were some differences regarding coping styles and flexibility preferences; however, this may be due to group differences in problem trajectory and care provision.

Type
Review Paper
Copyright
© The Author(s), 2021. Published by Cambridge University Press on behalf of the British Association for Behavioural and Cognitive Psychotherapies

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

Berry, C., & Hayward, M. (2011). What can qualitative research tell us about service user perspectives of CBT for psychosis? A synthesis of current evidence. Behavioural and Cognitive Psychotherapy, 39, 487494. doi: 10.1017/S1352465811000154 CrossRefGoogle ScholarPubMed
Brabban, A., Byrne, R., Longden, E., & Morrison, A. P. (2016). The importance of human relationships, ethics and recovery-orientated values in the delivery of CBT for people with psychosis. Psychosis: Psychological, Social and Integrative Approaches, 9, 157166 CrossRefGoogle Scholar
e-Learning for Healthcare (2021). Cognitive Behavioural Therapies for Psychosis. An elearning resource designed to demonstrate different types of therapy techniques. Retrieved from: https://www.e-lfh.org.uk/programmes/cognitive-behavioural-therapies-for-psychosis/ (a certificate is available if self-assessment is passed, and are evidence of learning for CPD purposes. Free access is available for staff working in the NHS).Google Scholar
Fadden, G., James, C. & Pinfold, V. (2012). Caring for Yourself – Self-Help for Families and Friends Supporting People With Mental Health Problems. Rethink Mental Illness and Meriden Family Programme. Birmingham: White Halo Design. Also available as a free online workbook: https://www.meridenfamilyprogramme.com/recovery/what-carers-families-and-friends-can-do-to-help-themselves/caring-for-yourself (exercises support coping skill development, i.e. communication skills, problem solving and goal achievement and relapse management).Google Scholar
French, P., & Morrison, A. (2004). Early Detection and Cognitive Therapy for People at High Risk of Developing Psychosis – A Treatment Manual. Chichester, UK: John Wiley.CrossRefGoogle Scholar
McGowan, J., Lavendar, T., & Garety, P. (2005). Factors in outcome of cognitive-behavioural therapy for psychosis: users’ and clinicians’ views. Psychology and Psychotherapy: Theory, Research and Practice, 78, 513529. doi: 10.1348/147608305X52559 CrossRefGoogle ScholarPubMed
Turkington, D., Hagen, R., Berge, T. & Grawe, R.W. (eds) (2013). CBT for Psychosis: A Symptom-Based Approach. London, UK: Routledge.Google Scholar

References

Addington, J., Cornblatt, B. A., Cadenhead, K. S., Cannon, T. D., McGlashan, T. H., Perkins, D. O., … & Woods, S. W. (2011a). At clinical high risk for psychosis: outcome for nonconverters. American Journal of Psychiatry, 168, 800805.CrossRefGoogle ScholarPubMed
Addington, J., Epstein, I., Liu, L., French, P., Boydell, K. M., & Zipursky, R. B. (2011b). A randomized controlled trial of cognitive behavioral therapy for individuals at clinical high risk of psychosis. Schizophrenia Research, 125, 5461.CrossRefGoogle ScholarPubMed
Allan, S. M., Hodgekins, J., Beazley, P., & Oduola, S. (2020). Pathways to care in at-risk mental states: a systematic review. Early Intervention in Psychiatry.Google Scholar
Aromataris, E., & Riitano, D. (2014). Constructing a search strategy and searching for evidence. American Journal of Nursing, 114, 4956.CrossRefGoogle ScholarPubMed
Barr, K., Ormrod, J., & Dudley, R. (2015). An exploration of what service users value about early intervention in psychosis services. Psychology and Psychotherapy: Theory, Research and Practice, 88, 468480.CrossRefGoogle ScholarPubMed
Ben-David, S., Cole, A., Brucato, G., Girgis, R. R., & Munson, M. R. (2019). Mental health service use decision-making among young adults at clinical high risk for developing psychosis. Early Intervention in Psychiatry, 13, 10501055.CrossRefGoogle ScholarPubMed
Berry, C., & Hayward, M. (2011). What can qualitative research tell us about service user perspectives of CBT for psychosis? A synthesis of current evidence. Behavioural and Cognitive Psychotherapy, 39, 487494. doi: 10.1017/S1352465811000154 CrossRefGoogle ScholarPubMed
Bettany-Saltikov, J. (2012). How to do a Systematic Literature Review in Nursing: A Step-by-Step Guide. McGraw-Hill Education, UK.Google Scholar
Bird, V., Premkumar, P., Kendall, T., Whittington, C., Mitchell, J., & Kuipers, E. (2010). Early intervention services, cognitive-behavioural therapy and family intervention in early psychosis: systematic review. British Journal of Psychiatry, 197, 350356.CrossRefGoogle ScholarPubMed
Boydell, K. M., Stasiulis, E., Volpe, T., & Gladstone, B. (2010). A descriptive review of qualitative studies in first episode psychosis. Early Intervention in Psychiatry, 4, 724.CrossRefGoogle ScholarPubMed
Britten, N., Campbell, R., Pope, C., Donovan, J., Morgan, M., & Pill, R. (2002). Using meta ethnography to synthesise qualitative research: a worked example. Journal of Health Services Research & Policy, 7, 209215.CrossRefGoogle ScholarPubMed
Byrne, R., & Morrison, A. P. (2010). Young people at risk of psychosis: a user-led exploration of interpersonal relationships and communication of psychological difficulties. Early Intervention in Psychiatry, 4, 162168.CrossRefGoogle ScholarPubMed
Byrne, R. E., & Morrison, A. P. (2014). Young people at risk of psychosis: their subjective experiences of monitoring and cognitive behaviour therapy in the early detection and intervention evaluation 2 trial. Psychology and Psychotherapy: Theory, Research and Practice, 87, 357371.CrossRefGoogle ScholarPubMed
CASP (2017). CASP (Qualitative Research) Checklist. Retrieved from: http://docs.wixstatic.com/ugd/dded87_25658615020e427da194a325e7773d42.pdf Google Scholar
Cox, L. (2021). Use of individual formulation in mental health practice. Mental Health Practice, 24, 3341.Google Scholar
Davidson, L., Bellamy, C., Guy, K., & Miller, R. (2012). Peer support among persons with severe mental illnesses: a review of evidence and experience. World Psychiatry, 11, 123128.CrossRefGoogle ScholarPubMed
Dixon-Woods, M., Cavers, D., Agarwal, S., Annandale, E., Arthur, A., Harvey, J., … & Smith, L. (2006). Conducting a critical interpretive synthesis of the literature on access to healthcare by vulnerable groups. BMC Medical Research Methodology, 6, 113.CrossRefGoogle ScholarPubMed
Ekers, D., Richards, D., McMillan, D., Bland, J. M., & Gilbody, S. (2011). Behavioural activation delivered by the non-specialist: phase II randomised controlled trial. British Journal of Psychiatry, 198, 6672.CrossRefGoogle ScholarPubMed
Favrod, J., Crespi, S., Faust, J. M., Polari, A., Bonsack, C., & Conus, P. (2011). A psychoeducation tool for patients with first-episode psychosis. Acta Neuropsychiatrica, 23, 7577.CrossRefGoogle Scholar
Finlay, L. (2006). ‘Rigour’, ‘ethical integrity ’or ‘artistry’? Reflexively reviewing criteria for evaluating qualitative research. British Journal of Occupational Therapy, 69, 319326.CrossRefGoogle Scholar
French, P., & Morrison, A. (2004). Early Detection and Cognitive Therapy for People at High Risk of Developing Psychosis – A Treatment Manual. Chichester, UK: John Wiley.CrossRefGoogle Scholar
Gee, B., Notley, C., Byrne, R., Clarke, T., Hodgekins, J., French, P., & Fowler, D. (2018). Young people’s experiences of Social Recovery Cognitive Behavioural Therapy and treatment as usual in the PRODIGY trial. Early Intervention in Psychiatry, 12, 879885.CrossRefGoogle ScholarPubMed
Hardy, K. V., Dickson, J. M., & Morrison, A. P. (2009). Journey into and through an early detection of psychosis service: the subjective experience of persons at risk of developing psychosis. Early Intervention in Psychiatry, 3, 5257.CrossRefGoogle ScholarPubMed
Harris, K., Collinson, C., & das Nair, R. (2012). Service-users’ experiences of an early intervention in psychosis service: an interpretative phenomenological analysis. Psychology and Psychotherapy: Theory, Research and Practice, 85, 456469.CrossRefGoogle ScholarPubMed
Heffernan, J., & Pilkington, P. (2011). Supported employment for persons with mental illness: systematic review of the effectiveness of individual placement and support in the UK. Journal of Mental Health, 20, 368380.CrossRefGoogle ScholarPubMed
Hewitt-Taylor, J. (2017). The Essential Guide to Doing a Health and Social Care Literature Review. Taylor & Francis.CrossRefGoogle Scholar
Hutton, P., & Taylor, P. J. (2014). Cognitive behavioural therapy for psychosis prevention: a systematic review and meta-analysis. Psychological Medicine, 44, 449.CrossRefGoogle ScholarPubMed
Izon, E., Au-Yeung, K., & Jones, W. (2020). The challenges of engaging individuals at high-risk of developing psychosis: reflections from research assistants within a randomised control trial. Psychosis, 19.Google Scholar
Kang, M., Bang, M., Lee, S. Y., Lee, E., Yoo, S. W., & An, S. K. (2018). Coping styles in individuals at ultra-high risk for psychosis: associations with cognitive appraisals. Psychiatry Research, 264, 162168.CrossRefGoogle ScholarPubMed
Kilbride, M., Byrne, R., Price, J., Wood, L., Barratt, S., Welford, M., & Morrison, A. P. (2013). Exploring service users’ perceptions of cognitive behavioural therapy for psychosis: a user led study. Behavioural and Cognitive Psychotherapy, 41, 89.CrossRefGoogle ScholarPubMed
Law, H., Izon, E., Au-Yeung, K., Morrison, A. P., Byrne, R., Notley, C., … & French, P. (2019). Combined individual and family therapy in comparison to treatment as usual for people at-risk of psychosis: a feasibility study (IF CBT): trial rationale, methodology and baseline characteristics. Early Intervention in Psychiatry, 15, 140148.CrossRefGoogle ScholarPubMed
Lester, H., Marshall, M., Jones, P., Fowler, D., Amos, T., Khan, N., & Birchwood, M. (2011). Views of young people in early intervention services for first-episode psychosis in England. Psychiatric Services, 62, 882887.CrossRefGoogle ScholarPubMed
Major, C. H., & Savin-Baden, M. (2010). An Introduction to Qualitative Research Synthesis: Managing the Information Explosion in Social Science Research. Routledge.Google Scholar
Marshall, M., & Rathbone, J. (2011). Early intervention for psychosis. Cochrane Database of Systematic Reviews, 6.CrossRefGoogle Scholar
Mayo, D., Corey, S., Kelly, L. H., Yohannes, S., Youngquist, A. L., Stuart, B. K., … & Loewy, R. L. (2017). The role of trauma and stressful life events among individuals at clinical high risk for psychosis: a review. Frontiers in Psychiatry, 8, 55.CrossRefGoogle ScholarPubMed
McCabe, J. L., & Holmes, D. (2009). Reflexivity, critical qualitative research and emancipation: a Foucauldian perspective. Journal of Advanced Nursing, 65, 15181526.CrossRefGoogle ScholarPubMed
McGorry, P. D., Killackey, E., & Yung, A. (2008). Early intervention in psychosis: concepts, evidence and future directions. World Psychiatry, 7, 148.CrossRefGoogle ScholarPubMed
McLeod, S. (2007). Maslow’s hierarchy of needs. Simply Psychology, 1, 18.Google Scholar
Mehl, S., Werner, D., & Lincoln, T. M. (2015). Does Cognitive Behavior Therapy for psychosis (CBTp) show a sustainable effect on delusions? A meta-analysis. Frontiers in Psychology, 6, 1450.CrossRefGoogle ScholarPubMed
Morrison, A. P., & Barratt, S. (2010). What are the components of CBT for psychosis? A Delphi study. Schizophrenia Bulletin, 36, 136142.CrossRefGoogle ScholarPubMed
Morrison, A. P., French, P., Stewart, S. L., Birchwood, M., Fowler, D., Gumley, A. I., … & Murray, G. K. (2012). Early detection and intervention evaluation for people at risk of psychosis: multisite randomised controlled trial. BMJ, 344, e2233.CrossRefGoogle ScholarPubMed
Moule, P., Aveyard, H., & Goodman, M. (2016). Nursing Research: An Introduction. Sage.Google Scholar
Munn, Z., Porritt, K., Lockwood, C., Aromataris, E., & Pearson, A. (2014). Establishing confidence in the output of qualitative research synthesis: the ConQual approach. BMC Medical Research Methodology, 14, 17.CrossRefGoogle ScholarPubMed
NICE (2014). Psychosis and Schizophrenia in Adults: Prevention and Management. Clinical Guideline CG178. London, UK: National Institute for Health and Care Excellence.Google Scholar
NICE (2020). Implementing the Early Intervention in Psychosis Access and Waiting Time Standard: Guidance. London, UK: National Collaborating Centre for Mental Health.Google Scholar
NICE and NHSE (2016). Implementing the Early intervention in Psychosis Access and Waiting Time Standard: Guidance. National Collaborating Centre for Mental Health.Google Scholar
Onwumere, J. (2018). Early psychosis services: carer focused psychoeducation and support-brief version. London Early Intervention Clinical Reference Group Report. Retrieved from: https://myhealth.london.nhs.uk/wp-content/uploads/2019/03/Carer-focused-education_support_review_AbbrevVersion_01_2019.pdf Google Scholar
Polit, D. F., & Beck, C. T. (2009). Essentials of Nursing Research: Appraising Evidence for Nursing Practice. Lippincott Williams & Wilkins.Google Scholar
Repper, J., & Carter, T. (2010). Using personal experience to support others with similar difficulties: a review of the literature on peer support in mental health services. London, UK: Together/University of Nottingham/NSUN.Google Scholar
Royal College of Psychiatrists (2016). Standards for Early Intervention in Psychosis Services. London, UK: Royal College of Psychiatrists.Google Scholar
Royal College of Psychiatrists & Early Intervention in Psychosis Network (2018). Standards for Early Intervention in Psychosis Services – 1st edn. CCQI285. London, UK: Early Intervention in Psychosis Network, Royal College of Psychiatrists’ Centre for Quality Improvement.Google Scholar
Royal College of Psychiatrists (2020). National Clinical Audit of Psychosis – National Report for the Early Intervention in Psychosis Spotlight Audit 2019/2020. London, UK: Healthcare Quality Improvement Partnership.Google Scholar
Ruggeri, M., Bonetto, C., Lasalvia, A., Fioritti, A., De Girolamo, G., Santonastaso, P., … & GET UP Group (2015). Feasibility and effectiveness of a multi-element psychosocial intervention for first-episode psychosis: results from the cluster-randomized controlled GET UP PIANO trial in a catchment area of 10 million inhabitants. Schizophrenia Bulletin, 41, 11921203.CrossRefGoogle Scholar
Stafford, M. R., Jackson, H., Mayo-Wilson, E., Morrison, A. P., & Kendall, T. (2013). Early interventions to prevent psychosis: systematic review and meta-analysis. British Medical Journal, 18, f185.CrossRefGoogle Scholar
Stain, H. J., Bucci, S., Baker, A. L., Carr, V., Emsley, R., Halpin, S., … & Crittenden, K. (2016). A randomised controlled trial of cognitive behaviour therapy versus non-directive reflective listening for young people at ultra high risk of developing psychosis: the detection and evaluation of psychological therapy (DEPTh) trial. Schizophrenia Research, 176, 212219.CrossRefGoogle ScholarPubMed
Stain, H. J., Mawn, L., Common, S., Pilton, M., & Thompson, A. (2019). Research and practice for ultra-high risk for psychosis: a national survey of early intervention in psychosis services in England. Early Intervention in Psychiatry, 13, 4752.CrossRefGoogle Scholar
Thomas, J., & Harden, A. (2008). Methods for the thematic synthesis of qualitative research in systematic reviews. BMC Medical Research Methodology, 8, 45.CrossRefGoogle ScholarPubMed
Uttinger, M., Koranyi, S., Papmeyer, M., Fend, F., Ittig, S., Studerus, E., Ramyead, A., Simon, A., & Riecher-Rössler, A. (2018). Early detection of psychosis: helpful or stigmatizing experience? A qualitative study. Early Intervention in Psychiatry, 12, 6673.CrossRefGoogle ScholarPubMed
Valmaggia, L. R., Tabraham, P., Morris, E., & Bouman, T. K. (2008). Cognitive behavioral therapy across the stages of psychosis: prodromal, first episode, and chronic schizophrenia. Cognitive and Behavioral Practice, 15, 179193.CrossRefGoogle Scholar
van der Gaag, M., Nieman, D. H., Rietdijk, J., Dragt, S., Ising, H. K., Klaassen, R. M., … & Linszen, D. H. (2012). Cognitive behavioral therapy for subjects at ultrahigh risk for developing psychosis: a randomized controlled clinical trial. Schizophrenia Bulletin, 38, 11801188.CrossRefGoogle ScholarPubMed
Waller, H., Craig, T., Landau, S., Fornells-Ambrojo, M., Hassanali, N., Iredale, C., … & Garety, P. (2014). The effects of a brief CBT intervention, delivered by frontline mental health staff, to promote recovery in people with psychosis and comorbid anxiety or depression (the GOALS study): study protocol for a randomized controlled trial. Trials, 15, 255.CrossRefGoogle ScholarPubMed
Welfare-Wilson, A., & Jones, A. (2015). A CBT-based anxiety management workshop in first-episode psychosis. British Journal of Nursing, 24, 378382.CrossRefGoogle ScholarPubMed
Welsh, P., & Tiffin, P. A. (2012). Observations of a small sample of adolescents experiencing an at-risk mental state (ARMS) for psychosis. Schizophrenia Bulletin, 38, 215218.CrossRefGoogle Scholar
White, H., Price, L., & Barker, T. (2017). Exploring the impact of peer support in early intervention in psychosis. Mental Health and Social Inclusion, 21, 102109.CrossRefGoogle Scholar
Wood, L., Burke, E., & Morrison, A. (2015). Individual cognitive behavioural therapy for psychosis (CBTp): a systematic review of qualitative literature. Behavioural and Cognitive Psychotherapy, 43, 285297.CrossRefGoogle ScholarPubMed
Submit a response

Comments

No Comments have been published for this article.