Recent Submissions

  • Developing an mHealth intervention to reduce COVID-19-associated psychological distress among health care workers in Nigeria: Protocol for a design and feasibility study

    Seun-Fadipe, Champion T. (2022)
    BACKGROUND: Globally, COVID-19-related psychological distress is seriously eroding health care workers' mental health and well-being, especially in low-income countries like Nigeria. The use of mobile health (mHealth) interventions is now increasingly recognized as an innovative approach that may improve mental health and well-being. This project aims to develop an mHealth psychological intervention (mPsyI) to reduce COVID-19-related psychological distress among health care workers in Nigeria. OBJECTIVE: Our objective is to present a study protocol to determine the level of COVID-19-related psychological distress among health care workers in Nigeria; explore health care workers' experience of COVID-19-related psychological distress; develop and pilot test mPsyI to reduce this distress; and assess the feasibility of this intervention (such as usability, engagement, and satisfaction). METHODS: A mixed (quantitative and qualitative) methods approach is used in which health care workers will be recruited from 2 tertiary health care facilities in southwest Nigeria. The study is divided into 4 phases based on the study objectives. Phase 1 involves a quantitative survey to assess the type and levels of psychosocial distress. Phase 2 collects qualitative data on psychosocial distress among health care workers. Phase 3 involves development of the mHealth-based psychological intervention, and phase 4 is a mixed methods study to assess the feasibility and acceptability of the intervention. RESULTS: This study was funded in November 2020 by the Global Effort on COVID-19 Health Research, and collection of preliminary baseline data started in July 2021. CONCLUSIONS: This is the first study to report the development of an mHealth-based intervention to reduce COVID-19-related psychological distress among health care workers in Nigeria. Using a mixed methods design in this study can potentially facilitate the adaptation of an evidence-based treatment method that is culturally sensitive and cost-effective for the management of COVID-19-related psychological distress among health care workers in Nigeria.
  • Developing an automated assessment of in-session patient activation for psychological therapy: Codevelopment approach

    Malins, Samuel; Manolescu, Cosmin; Higton, Fred; Waldram, David (2022)
    ACKGROUND: Patient activation is defined as a patient's confidence and perceived ability to manage their own health. Patient activation has been a consistent predictor of long-term health and care costs, particularly for people with multiple long-term health conditions. However, there is currently no means of measuring patient activation from what is said in health care consultations. This may be particularly important for psychological therapy because most current methods for evaluating therapy content cannot be used routinely due to time and cost restraints. Natural language processing (NLP) has been used increasingly to classify and evaluate the contents of psychological therapy. This aims to make the routine, systematic evaluation of psychological therapy contents more accessible in terms of time and cost restraints. However, comparatively little attention has been paid to algorithmic trust and interpretability, with few studies in the field involving end users or stakeholders in algorithm development. OBJECTIVE: This study applied a responsible design to use NLP in the development of an artificial intelligence model to automate the ratings assigned by a psychological therapy process measure: the consultation interactions coding scheme (CICS). The CICS assesses the level of patient activation observable from turn-by-turn psychological therapy interactions. METHODS: With consent, 128 sessions of remotely delivered cognitive behavioral therapy from 53 participants experiencing multiple physical and mental health problems were anonymously transcribed and rated by trained human CICS coders. Using participatory methodology, a multidisciplinary team proposed candidate language features that they thought would discriminate between high and low patient activation. The team included service-user researchers, psychological therapists, applied linguists, digital research experts, artificial intelligence ethics researchers, and NLP researchers. Identified language features were extracted from the transcripts alongside demographic features, and machine learning was applied using k-nearest neighbors and bagged trees algorithms to assess whether in-session patient activation and interaction types could be accurately classified. RESULTS: The k-nearest neighbors classifier obtained 73% accuracy (82% precision and 80% recall) in a test data set. The bagged trees classifier obtained 81% accuracy for test data (87% precision and 75% recall) in differentiating between interactions rated high in patient activation and those rated low or neutral. CONCLUSIONS: Coproduced language features identified through a multidisciplinary collaboration can be used to discriminate among psychological therapy session contents based on patient activation among patients experiencing multiple long-term physical and mental health conditions.
  • Patriarchal upbringing in the 21st century: The impact emotional abuse related to parental styles has on the genesis of gender inequality and the development of unresolved trauma in children

    Hankir, Ahmed (2022)
    Background: Violence Against Women and Girls (VAWG) (physical, sexual, and psychological/emotional) is a type of structural discrimination that violates the basic human rights of females on a global scale. Cultural norms that glorify male dominance, power imbalances, and abuse of authority are the most encountered reasons for VAWG. Emotional abuse, which can start in childhood, is widely recognised as the most prevalent form of VAWG. However, although victims of emotional abuse usually suffer terribly, perpetrators often evade accountability. Emotional abuse is underestimated in part because it is normalized by victims who are mostly women and girls. The normalization of VAWG is contributing to the propagation and perpetuation of biased perceptions of sexism. The intergenerational transmission of parenting styles - which is an important contributory factor for child development - often includes gender-stereotyping norms, or patriarchy. Hitherto, limited focus has been directed towards the consequences that emotional abuse related to patriarchal upbringing has on children. Aim - to investigate if emotional abuse related to patriarchal upbringing influences the perception of sexism and gender stereotyping across genders, and the development of unresolved trauma in children. Method(s): Participants were recruited via social media platforms to complete online questionnaires assessing parental emotional abuse, control, trauma, misogyny, and perceptions of sexism. Parametric analyses were conducted on the 188 participants (158 women and 30 men) recruited. Trauma and perceptions of sexism were statistically analysed using correlation and multiple linear regression. Result(s): Our findings show that parental emotional abuse and control in females predicted for unresolved traumatic experiences (16.6%). Misogynistic culture and male gender predicted for hostile sexism (9.9%), whereas emotional abuse predicted for benevolent sexism (40%). Conclusion(s): Emotional abuse related to patriarchal upbringing contributes to the genesis of gender inequality and unresolved trauma in children. Given that parental styles are transmitted from one generation to the next, to reduce sexism and improve mental health outcomes, the patriarchal parental cycle must be broken.
  • Positive psychology and attitudes to ageing in people aged 50 and over in the United Kingdom

    Orrell, Martin; Jones, Katy A. (2022)
    Objectives: The aim of this study was to investigate whether attitudes to ageing were associated with attitudes to positive psychology constructs.Methods: A cross-sectional online survey of 572 UK adults aged 50+ (mean age 64.6 years, SD = 8.4, 73.8% female) assessed attitudes to ageing using the Attitudes to Ageing Questionnaire (AAQ) in relation to measures of positive psychology including (1) belief in a just world-Just World Scale (JWS-Self and JWS-Other), (2) sense of coherence-Sense of Coherence Scale (SOC) and (3) positive well-being-Control, Autonomy, Self-Realization, and Pleasure Scale (CASP-19). Other factors included difficulties with hearing and eyesight, relative and carer status and demographics.Results: People with hearing and eyesight difficulties had lower CASP-19 and SOC scores, and more negative attitudes to ageing compared to people without sensory problems. Hierarchical regression analyses showed all three positive psychology scales predicted more positive attitudes to ageing. Being a carer for a person with dementia was associated with more negative attitudes to ageing.Conclusion: Whereas health and sensory problems relate to more negative attitudes to ageing, this study highlights the importance of positive psychological factors which could inform approaches seeking to promote well-being and health in older people.
  • Mental health of Indonesian university students: U.K. comparison and relationship between mental health shame and self-compassion

    Kotera, Yasuhiro (2022)
    While the Indonesian higher education has been growing rapidly, poor student mental health including a high level of mental health shame is a cause for concern in Indonesia. This study aimed to evaluate their mental health, shame, and self-compassion. One hundred fifty six participants completed self-report measures regarding mental health problems (depression, anxiety, and stress), mental health shame (negative attitudes, and external, internal, and reflected shame), and self-compassion. Data were first compared with 145 U.K. students, then correlation and regression analyses were performed. Indonesian students showed higher levels of mental health problems, family-related mental health shame, and self-compassion than U.K. students. Each type of mental health problem and mental health shame were positively associated with each other. Self-compassion was negatively associated with mental health problems, but not with mental health shame. Self-compassion was consistently the strongest predictor of mental health problems. Among the mental health shame types, only family external shame predicted the level of depression. Self-compassion training and mental health education for their family are recommended to protect the mental health of university students in Indonesia. (PsycInfo Database Record (c) 2022 APA, all rights reserved) (Source: journal abstract)
  • Pioneering an innovative intervention to reduce mental health related stigma in muslim communities: A protocol

    Hankir, Ahmed (2022)
    Despite the prevalence of mental health related stigma in Muslim communities, there are only a limited number of intervention studies reported in the literature. Digital interventions (i.e., YouTube clips, videos) are relatively cheap, highly accessible and easily disseminated and are increasingly being used to improve mental health literacy and reduce mental health related stigma. However, as far as the authors are aware, there are no stigma reduction programmes targeting Muslim communities that leverage digital interventions reported in the literature. This paper outlines a protocol for a digital intervention to challenge mental health related stigma in Muslim communities. The proposed intervention will be a 5 to 10-minute YouTube clip/video the active ingredients of which will be: [1] an interview with a Muslim expert by lived/living experience, [2] an Imam (Muslim faith leader) and [3] a psychiatrist. We will recruit members of Muslim communities living in Muslim minority countries in the Global North (United Kingdom, Unites States of America, Canada, Australia and New Zealand) to participate in the study (inclusion criteria: adults aged 18 years and over, Muslim background). The study will be comprised of two groups: an active group that will be exposed to the Muslim faith appropriate digital intervention and a control group that will be exposed to a digital intervention that is not Muslim faith appropriate. We will administer validated psychometric stigma scales on participants in both groups before and after exposure to the interventions. We hypothesize that viewing an anti-stigma clip/video that is Islamic faith appropriate will be associated with greater reductions in mental health related stigma in members of Muslim communities compared to viewing an anti-stigma clip/video that is not Islamic faith appropriate.
  • Emotional abuse in women and girls mediated by patriarchal upbringing and its impact on sexism and mental health: A narrative review

    Hankir, Ahmed (2022)
    Sexism is a type of structural discrimination that can manifest as the subjugation of woman in familial and social roles. Gender-based violence often occurs in societies where patriarchal norms exist. Violence against women and girls (VAWG) includes physical, sexual and psychological/emotional abuse directed towards females. Emotional violence against women and girls is usually underestimated, if not overlooked. Patriarchal upbringing can predominantly result in the emotional abuse of female children. This narrative review will discuss the impact emotional abuse in women and girls mediated by patriarchal upbringing has on sexism and mental health. This paper will also explore how gendered upbringing can contribute to the normalization of VAWG and the victim-blaming of females.
  • Design decisions and data completeness for experience sampling methods used in psychosis: systematic review

    Deakin, Emilia; Ng, Fiona; Young, Emma; Thorpe, Naomi; Craven, Michael P.; Slade, Mike (2022)
    Background: The experience sampling method (ESM) is an intensive longitudinal research method. Participants complete questionnaires at multiple times about their current or very recent state. The design of ESM studies is complex. People with psychosis have been shown to be less adherent to ESM study protocols than the general population. It is not known how to design studies that increase adherence to study protocols. A lack of typology makes it is hard for researchers to decide how to collect data in a way that allows for methodological rigour, quality of reporting, and the ability to synthesise findings. The aims of this systematic review were to characterise the design choices made in ESM studies monitoring the daily lives of people with psychosis, and to synthesise evidence relating the data completeness to different design choices. Methods: A systematic review was conducted of published literature on studies using ESM with people with psychosis. Studies were included if they used digital technology for data collection and reported the completeness of the data set. The constant comparative method was used to identify design decisions, using inductive identification of design decisions with simultaneous comparison of design decisions observed. Weighted regression was used to identify design decisions that predicted data completeness. The review was pre-registered (PROSPERO CRD42019125545). Results: 38 studies were included. A typology of design choices used in ESM studies was developed, which comprised three superordinate categories of design choice: Study context, ESM approach and ESM implementation. Design decisions that predict data completeness include type of ESM protocol used, length of time participants are enrolled in the study, and if there is contact with the research team during data collection. Conclusions: This review identified a range of design decisions used in studies using ESM in the context of psychosis. Design decisions that influence data completeness were identified. Findings will help the design and reporting of future ESM studies. Results are presented with the focus on psychosis, but the findings can be applied across different mental health populations.
  • Positive psychology and attitudes to ageing in people aged 50 and over in the United Kingdom

    Orrell, Martin; Jones, Katy A. (2022)
    Objectives: The aim of this study was to investigate whether attitudes to ageing were associated with attitudes to positive psychology constructs.Methods: A cross-sectional online survey of 572 UK adults aged 50+ (mean age 64.6 years, SD = 8.4, 73.8% female) assessed attitudes to ageing using the Attitudes to Ageing Questionnaire (AAQ) in relation to measures of positive psychology including (1) belief in a just world-Just World Scale (JWS-Self and JWS-Other), (2) sense of coherence-Sense of Coherence Scale (SOC) and (3) positive well-being-Control, Autonomy, Self-Realization, and Pleasure Scale (CASP-19). Other factors included difficulties with hearing and eyesight, relative and carer status and demographics.Results: People with hearing and eyesight difficulties had lower CASP-19 and SOC scores, and more negative attitudes to ageing compared to people without sensory problems. Hierarchical regression analyses showed all three positive psychology scales predicted more positive attitudes to ageing. Being a carer for a person with dementia was associated with more negative attitudes to ageing.Conclusion: Whereas health and sensory problems relate to more negative attitudes to ageing, this study highlights the importance of positive psychological factors which could inform approaches seeking to promote well-being and health in older people.
  • Recovery Colleges Characterisation and Testing in England (RECOLLECT): rationale and protocol

    Repper, Julie; Brewin, John; Meddings, Sarah; McPhilbin, Merly; Yeo, Caroline; Slade, Mike (2022)
    Recovery Colleges are a relatively recent initiative within mental health services. The first opened in 2009 in London and since then numbers have grown. They are based on principles of personal recovery in mental health, co-production between people with lived experience of mental health problems and professionals, and adult learning. Student eligibility criteria vary, but all serve people who use mental health services, with empirical evidence of benefit. Previously we developed a Recovery College fidelity measure and a preliminary change model identifying the mechanisms of action and outcomes for this group, which we refer to as service user students. The Recovery Colleges Characterisation and Testing (RECOLLECT) study is a five-year (2020–2025) programme of research in England. The aim of RECOLLECT is to determine Recovery Colleges’ effectiveness and cost-effectiveness, and identify organisational influences on fidelity and improvements in mental health outcomes. 
  • Recovery Colleges Characterisation and Testing in England (RECOLLECT): rationale and protocol

    Repper, Julie; Brewin, John; Sara, Meddings; McPhilbin, Merly; Yeo, Caroline; Slade, Mike (2022)
    Recovery Colleges are a relatively recent initiative within mental health services. The first opened in 2009 in London and since then numbers have grown. They are based on principles of personal recovery in mental health, co-production between people with lived experience of mental health problems and professionals, and adult learning. Student eligibility criteria vary, but all serve people who use mental health services, with empirical evidence of benefit. Previously we developed a Recovery College fidelity measure and a preliminary change model identifying the mechanisms of action and outcomes for this group, which we refer to as service user students. The Recovery Colleges Characterisation and Testing (RECOLLECT) study is a five-year (2020–2025) programme of research in England. The aim of RECOLLECT is to determine Recovery Colleges’ effectiveness and cost-effectiveness, and identify organisational influences on fidelity and improvements in mental health outcomes. 
  • Mental health workers’ perspectives on peer support in high-, middle- and low income settings: a focus group study

    Charles, Ashleigh (2022)
    Peer support is increasingly acknowledged as an integral part of mental health services around the world. However, most research on peer support comes from high-income countries, with little attention to similarities and differences between different settings and how these affect implementation. Mental health workers have an important role to play in integrating formal peer support into statutory services, and their attitudes toward peer support can represent either a barrier to or facilitator of successful implementation. Thus, this study investigates mental health workers’ attitudes toward peer support across a range of high- (Germany, Israel), middle- (India), and low-income country (Tanzania, Uganda) settings.
  • ‘Maybe I shouldn’t talk’: The role of power in the telling of mental health recovery stories

    Llewellyn-Beardsley, Joy; Rennick-Egglestone, Stefan; Ali, Yasmin; Watson, Emma; Yeo, Caroline; Ng, Fiona; Slade, Mike (2022)
    Mental health ?recovery narratives? are increasingly used within teaching, learning and practice environments. The mainstreaming of their use has been critiqued by scholars and activists as a co-option of lived experience for organisational purposes. But how people report their experiences of telling their stories has not been investigated at scale. We present accounts from 71 people with lived experience of multiple inequalities of telling their stories in formal and informal settings. A reflexive thematic analysis was conducted within a critical constructivist approach. Our overarching finding was that questions of power were central to all accounts. Four themes were identified: (1) Challenging the status quo; (2) Risky consequences; (3) Producing ?acceptable? stories; (4) Untellable stories. We discuss how the concept of narrative power foregrounds inequalities in settings within which recovery stories are invited and co-constructed, and conclude that power imbalances complicate the seemingly benign act of telling stories of lived experience.
  • Self-help digital interventions targeted at improving psychological well-being in young people with perceived or clinically diagnosed reduced well-being: Systematic review

    Babbage, Camilla M.; Jackson, Georgina M.; Davies, E. Bethan; Nixon, Elena (2022)
    Background: Levels of well-being are declining, whereas rates of mental health problems remain high in young people. The World Health Organization defines mental health as not merely the absence of mental disorder but also includes social and psychological well-being as integral to positive mental health, highlighting that mental health is applicable to young people with mental health conditions and those without a diagnosis of a mental health condition. Reduced mental well-being have been identified in studies of young people with clinical populations, as well as in populations consisting of nonclinical young people. Self-help digital interventions can be delivered at mass at a low cost and without the need for trained input, thereby facilitating access to support for well-being. Self-help interventions are effective in young people with mental health conditions, but systematic reviews of such studies have been limited to randomized controlled trials, have not included reduced well-being as an inclusion criterion, and do not consider engagement factors such as retention. Objective: The objective of this study was to systematically review all controlled studies of digitally delivered, self-administered interventions for young people aged 9 to 25 years, with perceived or clinically diagnosed reduced psychological well-being. Participant retention and effectiveness of the interventions were also explored. Methods: A systematic search of the PsycInfo, EMBASE, Cochrane, Scopus, and MEDLINE databases from inception to 2021, reference searches of relevant papers, and gray literature was carried out for digitally controlled studies conducted with young people with perceived or clinically diagnosed reduced well-being, aimed at improving psychological well-being. Data were extracted to identify the effectiveness and retention rates of the interventions and the quality of the studies. Results: Overall, 1.04% (12/1153) of studies met the inclusion criteria: 83% (10/12) of studies were randomized controlled trials and 17% (2/12) were controlled pre-post studies. Most (6/12, 50%) studies aimed to improve symptoms of depression; 3 interventions aimed at both anxiety and depressive symptoms and 2 studies aimed at improving social functioning difficulties. Owing to the high risk of bias across interventions and lack of similar outcome measures, a meta-analysis was not conducted. Retention rates across studies were regarded as good, with moderate to high retention. Overall, the findings indicated that predominantly self-administered self-help interventions improved well-being in the areas targeted by the intervention and identified additional areas of well-being that were positively affected by interventions. Few interventions supported psychological well-being that was different from those used by young people with a clinical diagnosis of mental illness or young people from neurodiverse backgrounds. Conclusions: The findings, along with the advantages of self-help interventions, highlight the need for upscaling self-help interventions to better support vulnerable populations of young people who experience poor psychological well-being. Trial Registration: PROSPERO CRD42019129321; https://tinyurl.com/4fb2t4fz
  • Taking a position within powerful systems

    Coles, Steven (2022)
    Psychiatric diagnosis remains the dominant model for conceptualising mental health difficulties and psychological distress. Psychiatric discourses rooted in the biomedical and biopsychosocial models are structurally embedded within service design throughout the UK and determine service provision, access to help and support, research grants, and overwhelmingly shape policy and legislation. Within this socio-political context, clinical and community psychologists continue to develop alternative conceptual frameworks and practices to counter individualising and arguably pathologising constructs of disorder and mental illness. As practitioners become increasingly outwardly looking and focus efforts on changing the underlying socio-materialist conditions that shape psychological distress, the need to recalibrate clinical psychology to address inequality, discrimination and social injustice as a matter of course is irrevocable. For many psychologists working in organisations designed on the basis of diagnostic discourses, the question as to how one positions themselves in-line with pre-existing psychiatric practices is crucial. Does one integrate approaches or question and challenge these psychiatric practices more overtly? Alternatively, could clinical and community psychology achieve a more ethical and conceptually coherent practice through activism to protest against the dominance of psychiatric diagnosis? This chapter explores how clinical psychologists position themselves in contexts where psychiatric diagnosis is the prevailing mode of practice, and it then goes on to explore what lessons clinical psychology can learn from community psychology when it comes to questions of psychological distress and psychiatric disorder. (PsycInfo Database Record (c) 2022 APA, all rights reserved) (Source: book)
  • An exploration of young people's experiences relating to stability and permanence throughout their care journey

    Woodall, Tamara; Browne, Kevin D.; Green, Kathleen; Majumder, Pallab (2022)
    Instability in the lives of young people in care is a public health concern. Placement moves and loss of relationships can have serious implications for young people's overall functioning, as well as their future life outcomes. Despite this, research often lacks the perspective and voice of young people in care. In this qualitative research, Interpretative Phenomenological Analysis was used to provide a deeper insight into young people's perceptions and beliefs about their care experiences to explore the impact of these on their ability to achieve a sense of stability and permanency across time. Semi-structured interviews were conducted with six males from UK foster, residential and semi-independent care homes. The main themes highlighted young people's perceptions of their care environment, relationships with others, sense of self and future under the overarching issue of permanence. Policy and practice implications propose strategies to target instability at the micro-level and how that may facilitate positive outcomes. The study revealed insights that may be helpful for frontline professionals and highlight to policy makers the importance of ensuring environmental and relational stability. An awareness of attachment theory to implement effective caregiving, should be a priority for training parents, caregivers, professionals and policy makers.
  • Impact of clinical decision-making participation and satisfaction on outcomes in mental health practice: results from the CEDAR European longitudinal study

    Slade, Mike (2022)
    The present study aimed to assess: (1) whether a more active involvement of patients is associated with an improvement of clinical symptoms, global functioning, and quality-of-life; and (2) how patients’ satisfaction with clinical decisions can lead to better outcome after 1 year. Data were collected as part of the study ‘Clinical decision-making and outcome in routine care for people with severe mental illness (CEDAR)’, a longitudinal observational study, funded by the European Commission and carried out in six European countries. Patients’ inclusion criteria were: (a) aged between 18 and 60 years; (b) diagnosis of a severe mental illness of any kind according to the Threshold Assessment Grid (TAG) ≥ 5 and duration of illness ≥ 2 years; (c) expected contact with the local mental health service during the 12-month observation period; (d) adequate skills in the language of the host countries; and (e) the ability to provide written informed consent. The clinical decision-making styles of clinicians and the patient satisfaction with decisions were assessed using the Clinical Decision Making Style and the Clinical Decision Making Involvement and Satisfaction scales, respectively. Patients were assessed at baseline and 1 year after the recruitment. The sample consisted of 588 patients with severe mental illness, mainly female, with a mean age of 41.69 (±10.74) and a mean duration of illness of 12.5 (±9.27) years. The majority of patients were diagnosed with psychotic (45.75%) or affective disorders (34.01%). At baseline, a shared CDM style was preferred by 70.6% of clinicians and about 40% of patients indicated a high level of satisfaction with the decision and 31% a medium level of satisfaction. Higher participation in clinical decisions was associated with improved social functioning and quality-of-life, and reduced interpersonal conflicts, sense of loneliness, feelings of inadequacy, and withdrawal in friendships after 1 year (p < 0.05). Moreover, a higher satisfaction with decisions was associated with a better quality-of-life (p < 0.0001), reduced symptom severity (p < 0.0001), and a significantly lower illness burden associated with symptoms of distress (p < 0.0001), interpersonal difficulties (p < 0.0001), and problems in social roles (p < 0.05). Our findings clearly show that a higher involvement in and satisfaction of patients with clinical decision-making was associated with better outcomes. More efforts have to be made to increase the involvement of patients in clinical decision-making in routine care settings. © 2022 Institute of Psychiatry and Johns Hopkins University.
  • Posttraumatic growth and recovery among a sample of Egyptian mental health service users: a phenomenological study

    Ng, Fiona; Slade, Mike (2022)
    BACKGROUNDDelivery of recovery-oriented mental health practice is fundamental to personal recovery. Yet, there is lack of service users' accounts on what constitutes mental health recovery in Egypt.OBJECTIVESThe aim of this study was to explore mental health recovery meaning informed by people with personal experience of recovery.METHODSA phenomenological research design was used. Semi-structured qualitative interviews were conducted with 17 adult community-dwelling individuals who identified as recovered/recovering from mental health issues. An inductive thematic analysis approach was used to analyses participants' responses.RESULTSParticipants predominately reported personal and functional definitions of mental health recovery. Posttraumatic growth was the strongest theme comprising: relation to others, spirituality, new possibilities, identity & strengths, and appreciation of life. Themes of acceptance and forgiveness, functional and clinical recovery, and finding hope were also identified.CONCLUSIONSThis is the first study to explore mental health recovery meaning among a sample of people with lived experience of mental health issues in Egypt. Findings suggest that developing and implementing psychosocial interventions to support posttraumatic growth among people with mental health issues is a priority.
  • Character strength-focused positive psychotherapy on acute psychiatric wards: A feasibility and acceptability study

    Slade, Mike (2022)
    OBJECTIVEA manualized single-session positive psychotherapy intervention was developed and tested on acute psychiatric wards.METHODSParticipants were invited in 2018-2019 to identify positive experiences, link them to a personal character strength, and plan a strengths-based activity. The intervention's feasibility was evaluated through fidelity to session components, character strengths identification, and activity completion. Acceptability was evaluated with self-reported pre- and postsession mood ratings, a postsession helpfulness rating, and narrative feedback.RESULTSParticipants (N=70) had complex and severe mental health conditions. In 18 group sessions, 89% of components were delivered with fidelity; 80% of the participants identified a character strength, of whom 71% identified a strengths-based activity, and 58% completed the activity. The mean±SD helpfulness rating (N=23) was 8.5±1.5 (on a 10-point Likert scale), and positive mood significantly increased postsession (5.9 presession vs. 7.2 postsession).CONCLUSIONSPositive psychotherapy is feasible in challenging inpatient settings, and service users with severe and complex mental health conditions find it helpful.
  • Automated virtual reality cognitive therapy (gameChange) in inpatient psychiatric wards: Qualitative study of staff and patient views using an implementation framework

    Jones, Julia (2022)
    BACKGROUNDAutomated virtual reality (VR) therapy could allow a greater number of patients to receive evidence-based psychological therapy. The aim of the gameChange VR therapy is to help patients overcome anxious avoidance of everyday social situations. gameChange has been evaluated with outpatients, but it may also help inpatients prepare for discharge from psychiatric hospital.OBJECTIVEThe aim of this study is to explore the views of patients and staff on the provision of VR therapy on psychiatric wards.METHODSFocus groups or individual interviews were conducted with patients (n=19) and National Health Service staff (n=22) in acute psychiatric wards. Questions were derived from the nonadoption, abandonment, and challenges to the scale-up, spread, and sustainability framework. Expectations of VR therapy were discussed, and participants were then given the opportunity to try out the gameChange VR therapy before they were asked questions that focused on opinions about the therapy and feasibility of adoption.RESULTSThere was great enthusiasm for the use of gameChange VR therapy on psychiatric wards. It was considered that gameChange could help build confidence, reduce anxiety, and "bridge that gap" between the differences of being in hospital and being discharged to the community. However, it was reflected that the VR therapy may not suit everyone, especially if they are acutely unwell. VR on hospital wards for entertainment and relaxation was also viewed positively. Participants were particularly impressed by the immersive quality of gameChange and the virtual coach. It was considered that a range of staff groups could support VR therapy delivery. The staff thought that implementation would be facilitated by having a lead staff member, having ongoing training accessible, and involving the multidisciplinary team in decision-making for VR therapy use. The most significant barrier to implementation identified by patients and staff was a practical one: access to sufficient, private space to provide the therapy.CONCLUSIONSPatients and staff were keen for VR to be used on psychiatric wards. In general, patients and staff viewed automated VR therapy as possible to implement within current care provision, with few significant barriers other than constraints of space. Patients and staff thought of many further uses of VR on psychiatric wards. The value of VR therapy on psychiatric wards now requires systematic evaluation.INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID)RR2-10.2196/20300.

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