Exploring views about mindfulness groups for voice-hearing from the perspective of service users and staff: A Q-methodology study.

OBJECTIVES: Despite prevailing beliefs about the potential benefits and harmfulness of mindfulness for people who hear voices, there is a paucity of research into staff and service user views. Q-methodology was used to explore views about mindfulness groups for voice-hearers. METHOD: Opportunistic sampling of mental healthcare staff (N = 14) and service users with psychosis (N = 17). Both samples were analysed using principle components factor analysis to identify the range of attitudes held by staff and service users. RESULTS: Staff participants were particularly knowledgeable and interested in mindfulness. A single staff consensus factor was found suggesting mindfulness is helpful, and not harmful for mental health, but uncertainty surrounded its usefulness for voice-hearers. Service users held four distinct attitudes: (i) mindfulness helps to calm a racing mind; (ii) mindfulness helps to manage stress; (iii) mindfulness improves well-being, and does not alter the brain, reality beliefs, or cause madness; and (iv) mindfulness helps with managing thoughts, fostering acceptance, and is acceptable when delivered in a group format. CONCLUSIONS: Staff viewed mindfulness groups for psychosis as helpful, not harmful, but were uncertain about their utility. Consistent with previous research, service users viewed mindfulness groups as useful to promote well-being and reduce distress for individuals experiencing psychosis.

Mindfulness-Based Cognitive Therapy for Psychosis: Measuring Psychological Change Using Repertory Grids.

There are an increasing, but limited, number of studies investigating the benefits of mindfulness interventions for people experiencing psychosis. To our knowledge, changes following mindfulness for psychosis have not yet been explored from a personal construct perspective. This study had two main aims: (i) to explore changes in the way a person construes their self, others and their experience of psychosis following a Mindfulness-Based Cognitive Therapy (MBCT) group; and (ii) to replicate the findings of other studies exploring the feasibility and potential benefits of MBCT for psychosis. Sixteen participants, with experience of psychosis, completed an 8-week MBCT group. Participants completed pre-group and post-group assessments including a repertory grid, in addition to a range of outcome measures. There was some evidence of changes in construing following MBCT, with changes in the way participants viewed their ideal self and recovered self, and an indication of increased self-understanding. Improvements were found in participants' self-reported ability to act with awareness and in recovery. This study demonstrates the feasibility and potential benefits of MBCT groups for people experiencing psychosis. Furthermore, it provides some evidence of changes in construal following MBCT that warrant further exploration. Large-scale controlled trials of MBCT for psychosis are needed, as well as studies investigating the mechanisms of change. Copyright © 2015 John Wiley & Sons, Ltd. KEY PRACTITIONER MESSAGE: MBCT may contribute to change in individuals' perceptions and increase self-understanding. The study highlights the importance of measuring change in recovery following MBCT. Findings support the need for person-centred approaches to assessment and monitoring of personal change following therapy. Similar studies using a control group are needed in order to identify whether the changes found are attributable to participation in an MBCT group. Copyright © 2015 John Wiley & Sons, Ltd.

A mixed-method investigation of patient monitoring and enhanced feedback in routine practice: Barriers and facilitators.

OBJECTIVE: To investigate the barriers and facilitators of an effective implementation of an outcome monitoring and feedback system in a UK National Health Service psychological therapy service. METHOD: An outcome monitoring system was introduced in two services. Enhanced feedback was given to therapists after session 4. Qualitative and quantitative methods were used, including questionnaires for therapists and patients. Thematic analysis was carried out on written and verbal feedback from therapists. Analysis of patient outcomes for 202 episodes of therapy was compared with benchmark data of 136 episodes of therapy for which feedback was not given to therapists. RESULTS: Themes influencing the feasibility and acceptability of the feedback system were the extent to which therapists integrated the measures and feedback into the therapy, availability of administrative support, information technology, and complexity of the service. There were low levels of therapist actions resulting from the feedback, including discussing the feedback in supervision and with patients. CONCLUSIONS: The findings support the feasibility and acceptability of setting up a routine system in a complex service, but a number of challenges and barriers have to be overcome and therapist differences are apparent. More research on implementation and effectiveness is needed in diverse clinical settings.