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Patient experience of Guided self-help CBT intervention for VoicEs (GiVE) delivered within a pilot randomized controlled trial

Published online by Cambridge University Press:  06 October 2020

Cassie M. Hazell Open the ORCID record for Cassie M. Hazell [Opens in a new window] ,
Orla Kelly ,
Sorcha O’Brien ,
Clara Strauss Open the ORCID record for Clara Strauss [Opens in a new window] ,
Kate Cavanagh  and
Mark Hayward Open the ORCID record for Mark Hayward [Opens in a new window]
Cassie M. Hazell*
Affiliation:
School of Social Sciences, University of Westminster, LondonW1W 6UW, UK School of Psychology, University of Sussex, Falmer, BrightonBN1 9QJ, UK
Orla Kelly
Affiliation:
School of Psychology, University of Sussex, Falmer, BrightonBN1 9QJ, UK
Sorcha O’Brien
Affiliation:
School of Psychology, University of Sussex, Falmer, BrightonBN1 9QJ, UK
Clara Strauss
Affiliation:
School of Psychology, University of Sussex, Falmer, BrightonBN1 9QJ, UK R&D Department, Sussex Partnership NHS Foundation Trust, Sussex Education Centre, HoveBN3 7HZ, UK
Kate Cavanagh
Affiliation:
School of Psychology, University of Sussex, Falmer, BrightonBN1 9QJ, UK
Mark Hayward
Affiliation:
School of Psychology, University of Sussex, Falmer, BrightonBN1 9QJ, UK R&D Department, Sussex Partnership NHS Foundation Trust, Sussex Education Centre, HoveBN3 7HZ, UK
*
*Corresponding author. Email: [email protected]
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Abstract

Access to cognitive behaviour therapy for those with psychosis (CBTp) remains poor. The most frequently endorsed barrier to implementation is a lack of resources. To improve access to CBTp, we developed a brief form of CBTp that specifically targets voice-related distress. The results of our pilot trial of guided self-help CBT for voices (GiVE) suggest that the therapy is both acceptable and beneficial. The present study aims to explore the subjective patient experience of accessing GiVE in the context of a trial. We interviewed nine trial participants using the Change Interview and a mixed methods approach. Most participants reported at least one positive change that they attributed to GiVE. We extracted five themes: (1) changes that I have noticed; (2) I am not alone; (3) positive therapy experiences; (4) I want more therapy; and (5) helping myself. The themes indicate that participating in the GiVE trial was generally a positive experience. The main areas in which participants experienced changes were improved self-esteem, and the ability to cope with voices. Positive changes were facilitated by embracing and enacting ‘self-help’ and having support both in and out of the therapy sessions. The findings support the use of self-help materials with those distressed by hearing voices, but that support both within and outside the clinical setting can aid engagement and outcomes. Overall, the findings support the continued investigation of GiVE.

Key learning aims

  1. (1) To explore participants’ experience of accessing GiVE as part of a trial.

  2. (2) To identify what (if any) changes participants noticed over the course of the GiVE trial.

  3. (3) To identify what participants attribute these changes to.

Keywords

CBTcognitive behaviour therapyhearing voicespsychosisself-help
Type
Original Research
Information
the Cognitive Behaviour Therapist , Volume 13 , 2020 , e40
Copyright
© British Association for Behavioural and Cognitive Psychotherapies 2020

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References

Further reading

Hazell, C. M., Hayward, M., Cavanagh, K., Jones, A.-M., & Strauss, C. (2016). Guided self-help cognitive behavioral intervention for VoicEs (GiVE): study protocol for a pilot randomized controlled trial. Trials, 17. https://doi.org/10.1186/s13063-016-1494-yCrossRefGoogle ScholarPubMed
Hazell, C. M., Hayward, M., Cavanagh, K., Jones, A.-M., & Strauss, C. (2017). Guided self-help cognitive-behaviour Intervention for VoicEs (GiVE): results from a pilot randomised controlled trial in a transdiagnostic sample. Schizophrenia Research. https://doi.org/10.1016/j.schres.2017.10.004Google Scholar
Hazell, C. M., Hayward, M., Cavanagh, K., & Strauss, C. (2016). A systematic review and meta-analysis of low intensity CBT for psychosis. Clinical Psychology Review, 45, 183–192. https://doi.org/10.1016/j.cpr.2016.03.004CrossRefGoogle ScholarPubMed
Hazell, C. M., Hayward, M., Strauss, C., & Kingdon, D. (2018). An Introduction to Self-Help for Distressing Voices. London, UK: Robinson.Google Scholar

References

Birchwood, M., & Chadwick, P. (1997). The omnipotence of voices: testing the validity of a cognitive model. Psychological Medicine, 27, 1345–1353. https://doi.org/10.1017/S0033291797005552CrossRefGoogle ScholarPubMed
Braun, V., & Clarke, V. (2006). Using thematic analysis in psychology. Qualitative Research in Psychology, 3, 77–101. https://doi.org/10.1191/1478088706qp063oaCrossRefGoogle Scholar
Chadwick, P., & Birchwood, M. (1994). The omnipotence of voices. British Journal of Psychiatry, 164, 190–201. https://doi.org/doi:10.1192/bjp.164.2.190CrossRefGoogle ScholarPubMed
Clark, D. M., Layard, R., Smithies, R., Richards, D. A., Suckling, R., & Wright, B. (2009). Improving access to psychological therapy: initial evaluation of two UK demonstration sites. Behaviour Research and Therapy, 47, 910–920. https://doi.org/10.1016/j.brat.2009.07.010CrossRefGoogle ScholarPubMed
Clarke, V., & Braun, V. (2013). Successful Qualitative Research: A Practical Guide for Beginners. London, UK: Sage.Google Scholar
Cole, E. R., Strauss, C., Fife-Schaw, C., & McCarthy-Jones, S. (2017). Echoes of others: a path analytic examination of an interpersonal-cognitive model of voice-related distress. Psychology and Psychotherapy: Theory, Research and Practice. https://doi.org/10.1111/papt.12129CrossRefGoogle ScholarPubMed
Dixon, L. B., Holoshitz, Y., & Nossel, I. (2016). Treatment engagement of individuals experiencing mental illness: review and update. World Psychiatry, 15, 13–20. https://doi.org/10.1002/wps.20306CrossRefGoogle ScholarPubMed
Eassom, E., Giacco, D., Dirik, A., & Priebe, S. (2014). Implementing family involvement in the treatment of patients with psychosis: a systematic review of facilitating and hindering factors. BMJ Open, 4, 1–11. https://doi.org/10.1136/bmjopen-2014-006108CrossRefGoogle ScholarPubMed
Elliott, R., Slatick, E., & Urman, M. (2001). Qualitative change process research on psychotherapy: alternative strategies. Psychologische Beiträge, 43, 69–111. Retrieved from: http://search.proquest.com/openview/a0e961b9dd139438a4a8f170d5566a08/1?pq-origsite=gscholar&cbl=43472Google Scholar
Fielding-Smith, S. F., Hayward, M., Strauss, C., Fowler, D., Paulik, G., & Thomas, N. (2015). Bringing the ‘self’ into focus: conceptualising the role of self-experience for understanding and working with distressing voices. Frontiers in Psychology, 6, 1129. https://doi.org/10.3389/fpsyg.2015.01129CrossRefGoogle ScholarPubMed
Garety, P. A., Fowler, D. G., Freeman, D., Bebbington, P., Dunn, G., & Kuipers, E. (2008). Cognitive-behavioural therapy and family intervention for relapse prevention and symptom reduction in psychosis: randomised controlled trial. British Journal of Psychiatry, 192, 412–423. https://doi.org/10.1192/bjp.bp.107.043570CrossRefGoogle ScholarPubMed
Hayward, M., Strauss, C., & Kingdon, D. (2012). Overcoming Distressing Voices. London, UK: Constable & Robinsons Ltd.Google Scholar
Hayward, Mark, Berry, C., Cameron, B., Arnold, K., Berry, K., Bremner, S., … & Strauss, C. (2020). Increasing access to CBT for psychosis patients: a feasibility, randomised controlled trial evaluating brief, targeted CBT for distressing voices delivered by assistant psychologists (GiVE2). Trials, 21, 1–14. https://doi.org/10.1186/s13063-020-4181-yCrossRefGoogle Scholar
Hayward, M., Bogen-Johnston, L., & Deamer, F. (2018). Relating therapy for distressing voices: who, or what, is changing? Psychosis, 10, 132–141. https://doi.org/10.1080/17522439.2018.1469037CrossRefGoogle Scholar
Hazell, C. M., Hayward, M., Cavanagh, K., Jones, A.-M., & Strauss, C. (2016a). Guided self-help cognitive behavioral intervention for VoicEs (GiVE): study protocol for a pilot randomized controlled trial. Trials, 17. https://doi.org/10.1186/s13063-016-1494-yCrossRefGoogle ScholarPubMed
Hazell, C. M, Hayward, M., Cavanagh, K., Jones, A.-M., & Strauss, C. (2017a). Guided self-help cognitive-behaviour Intervention for VoicEs (GiVE): results from a pilot randomised controlled trial in a transdiagnostic sample. Schizophrenia Research. https://doi.org/10.1016/j.schres.2017.10.004Google Scholar
Hazell, C. M., Hayward, M., Cavanagh, K., & Strauss, C. (2016b). A systematic review and meta-analysis of low intensity CBT for psychosis. Clinical Psychology Review, 45, 183–192. https://doi.org/10.1016/j.cpr.2016.03.004CrossRefGoogle ScholarPubMed
Hazell, C. M, Hayward, M., Strauss, C., & Kingdon, D. (2018). An Introduction to Self-Help for Distressing Voices. London, UK: Robinson.Google Scholar
Hazell, C. M., Strauss, C., Cavanagh, K., & Hayward, M. (2017b). Barriers to disseminating brief CBT for voices from a lived experience and clinician perspective. PLoS ONE, 12. https://doi.org/10.1371/journal.pone.0178715CrossRefGoogle ScholarPubMed
Hengartner, M. P., Müller, M., Rodgers, S., Rössler, W., & Ajdacic-Gross, V. (2014). Interpersonal functioning deficits in association with DSM-IV personality disorder dimensions. Social Psychiatry and Psychiatric Epidemiology, 49, 317–325. https://doi.org/10.1007/s00127-013-0707-xCrossRefGoogle ScholarPubMed
Hill, J., Stepp, S. D., Wan, M. W., Hope, H., Morse, J. Q., Steele, M., … & Pilkonis, P. A. (2011). Attachment, borderline personality, and romantic relationship dysfunction. Journal of Personality Disorders, 25, 789–805. https://doi.org/10.1521/pedi.2011.25.6.789CrossRefGoogle ScholarPubMed
Ince, P., Haddock, G., & Tai, S. (2015). A systematic review of the implementation of recommended psychological interventions for schizophrenia: rates, barriers, and improvement strategies. Psychology and Psychotherapy: Theory, Research and Practice. https://doi.org/10.1111/papt.12084Google ScholarPubMed
Kuipers, E. (2011). Cognitive behavioural therapy and family intervention for psychosis – evidence-based but unavailable? The next steps. Psychoanalytic Psychotherapy, 25, 69–74. https://doi.org/10.1080/02668734.2011.542966CrossRefGoogle Scholar
Larøi, F., Thomas, N., Aleman, A., Fernyhough, C., Wilkinson, S., Deamer, F., & McCarthy-Jones, S. (2019). The ice in voices: understanding negative content in auditory-verbal hallucinations. Clinical Psychology Review, 67, 1–10. https://doi.org/10.1016/j.cpr.2018.11.001CrossRefGoogle ScholarPubMed
Lim, M. H., Gleeson, J. F. M., Alvarez-Jimenez, M., & Penn, D. L. (2018). Loneliness in psychosis: a systematic review. Social Psychiatry and Psychiatric Epidemiology, 53, 221–238. https://doi.org/10.1007/s00127-018-1482-5CrossRefGoogle ScholarPubMed
Lincoln, T. M., & Peters, E. (2018). A systematic review and discussion of symptom specific cognitive behavioural approaches to delusions and hallucinations. Schizophrenia Research. https://doi.org/10.1016/j.schres.2017.12.014Google ScholarPubMed
NICE (2014). Psychosis and schizophrenia in adults: prevention and management. London, UK: National Institute for Health and Care Excellence (NICE).Google Scholar
Notley, C., Christopher, R., Hodgekins, J., Byrne, R., French, P., & Fowler, D. (2015). Participant views on involvement in a trial of social recovery cognitive-behavioural therapy. British Journal of Psychiatry, 206, 122–127. https://doi.org/10.1192/bjp.bp.114.146472CrossRefGoogle Scholar
Paulik, G., Hayward, M., Jones, A. M., & Badcock, J. C. (2019). Evaluating the ‘C’ and ‘B’ in brief cognitive behaviour therapy for distressing voices in routine clinical practice in an uncontrolled study. Clinical Psychology and Psychotherapy, 26, 734–742. https://doi.org/10.1002/cpp.2395CrossRefGoogle Scholar
Prytys, M., Garety, P., Jolley, S., Onwumere, J., & Craig, T. (2011). Implementing the NICE guideline for schizophrenia recommendations for psychological therapies: a qualitative analysis of the attitudes of CMHT staff. Clinical Psychology and Psychotherapy, 18, 48–59. https://doi.org/10.1002/cpp.691CrossRefGoogle ScholarPubMed
Rosenberg, M. (1965). Society and the Adolescent Self-Image. Princeton University Press.CrossRefGoogle Scholar
Sayer, J., Ritter, S., & Gournay, K. (2000). Beliefs about voices and their effects on coping strategies. Journal of Advanced Nursing, 31, 1199–1205. https://doi.org/10.1046/j.1365-2648.2000.01375.xCrossRefGoogle ScholarPubMed
Singh, G., Sharan, P., & Kulhara, P. (2003). Role of coping strategies and attitudes in mediating distress due to hallucinations in schizophrenia. Psychiatry and Clinical Neurosciences, 57, 517–522. https://doi.org/10.1046/j.1440-1819.2003.01157.xCrossRefGoogle Scholar
Sorrell, E., Hayward, M., & Meddings, S. (2010). Interpersonal processes and hearing voices: a study of the association between relating to voices and distress in clinical and non-clinical hearers. Behavioural and Cognitive Psychotherapy, 38, 127–140.CrossRefGoogle ScholarPubMed
The Royal College of Psychiatrists (2018). National Clinical Audit of Psychosis: National report of the core audit. London.Google Scholar
Thomas, N. (2015). What’s really wrong with cognitive behavioral therapy for psychosis? Frontiers in Psychology, 6, 1–4. https://doi.org/10.3389/fpsyg.2015.00323CrossRefGoogle ScholarPubMed
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