Young people's beliefs about psychological therapy for psychosis: a Q-Methodological study.

Background: The evidence base for the use of psychological therapies in the treatment of psychosis is growing, however engagement can be difficult and outcomes are variable. Beliefs, attitudes and expectations may have an important influence on whether individuals engage with therapy and on clinical outcomes, however, these beliefs have not been adequately explored.Aims: To examine what young people in Early Intervention Services (EIS) think about psychological therapies for psychosis.Method: Thirty participants were recruited from EIS across five NHS trusts to examine young people's beliefs about psychological therapy.Results: Four distinct factors, or sets of beliefs, about therapy emerged: (1) Therapy is helpful and gives hope for the future; (2) Therapy is just talking, people need medication; (3) Therapy is useful but stigmatising; (4) Therapy is better than medication. Positive views towards different aspects of therapy were present in all four accounts. Other important issues were raised, including concerns about stigma and opposing beliefs about medication.Conclusion: These four factors provide useful insights into young people's beliefs about psychological therapy. Individuals' beliefs and expectations should be recognised and explored in order to promote greater engagement in and better outcomes from therapy.

Self-esteem and relapse in schizophrenia: a 5-year follow-up study.

This study investigated the association between an interview-based measure of self-esteem and subsequent clinical outcome in recent-onset schizophrenia. A cohort 5-year follow-up design with retrospective chart assessment of clinical outcomes was used. Relapse rates during 5 years were very high, with 92% of the sample relapsing. Self-esteem consisted of two dimensions, negative evaluation of self (NES) and positive evaluation of self (PES). Survival analysis indicated that high NES was significantly associated with shorter time to relapse; and PES, with longer survival time. The participants with high PES were three times more likely to have delayed relapse; no other covariates were significant. PES seemed to buffer the adverse effects of NES. The results indicate that social cognition in the form of self-evaluation may be implicated in clinical outcome and symptom exacerbation in schizophrenia.This study investigated the association between an interview-based measure of self-esteem and subsequent clinical outcome in recent-onset schizophrenia. A cohort 5-year follow-up design with retrospective chart assessment of clinical outcomes was used. Relapse rates during 5 years were very high, with 92% of the sample relapsing. Self-esteem consisted of two dimensions, negative evaluation of self (NES) and positive evaluation of self (PES). Survival analysis indicated that high NES was significantly associated with shorter time to relapse; and PES, with longer survival time. The participants with high PES were three times more likely to have delayed relapse; no other covariates were significant. PES seemed to buffer the adverse effects of NES. The results indicate that social cognition in the form of self-evaluation may be implicated in clinical outcome and symptom exacerbation in schizophrenia.

Individuals' experiences and opinions of psychological therapies for psychosis: A narrative synthesis.

Beliefs, attitudes and expectations about therapy are likely to influence engagement, adherence and outcomes in psychological therapy but despite increased research interest in this area, the evidence has not been systematically reviewed or synthesised. This review is the first to explore service user beliefs by synthesising existing quantitative and qualitative research in order to develop a comprehensive understanding of beliefs about psychological therapy in people with psychosis and to identify gaps in the literature. Thirty-five papers were included in this review and synthesised. Themes and subthemes of both service user expectations (including outcomes, process and barriers) and experiences (including satisfaction, outcomes, process and therapist characteristics) are described. High levels of satisfaction and positive regard towards therapy for psychosis were found. However, many clients refuse, do not attend or withdraw from psychological therapy. Data were primarily limited to people who have completed therapy. Expectations about therapy have not been adequately addressed and warrant further exploration. Understanding and managing expectations, including consideration of fears, misconceptions, and potential challenges, could promote engagement. Exploration of beliefs, particularly in those who refuse or terminate therapy, is essential to further our understanding of factors affecting services users' decision-making processes, as well as the efficacy of therapy.