A qualitative study of the acceptability of cognitive bias modification for paranoia (CBM-pa) in patients with psychosis

Abstract

Background: Cognitive Bias Modification (CBM) has been used successfully as a computer-based intervention in disorders such as anxiety. However, CBM to modify interpretations of ambiguous information relevant to paranoia has not yet been tested. We conducted a qualitative investigation of a novel intervention called CBM for paranoia (CBM-pa) to examine its acceptability in patients with psychosis. Methods: Eight participants with psychosis who completed CBM-pa were identified by purposive sampling and invited for a semi-structured interview to explore the facilitators and barriers to participation, optimum form of delivery, perceived usefulness of CBM-pa and their opinions on applying CBM-pa as a computerised intervention. The interviews were transcribed and analysed using thematic analysis by researchers working in collaboration with service users. Results: Themes emerged relating to participants' perception about delivery, engagement, programme understanding, factors influencing experience, perceived impact and application of CBM-pa. CBM-pa was regarded as easy, straightforward and enjoyable. It was well-accepted among those we interviewed, who understood the procedure as a psychological intervention. Patients reported that it increased their capacity for adopting alternative interpretations of emotionally ambiguous scenarios. Although participants all agreed on the test-like nature of the current CBM-pa format, they considered that taking part in sessions had improved their overall wellbeing. Most of them valued the computer-based interface of CBM-pa but favoured the idea of combining CBM-pa with some form of human interaction. Conclusions: CBM-pa is an acceptable intervention that was well-received by our sample of patients with paranoia. The current findings reflect positively on the acceptability and experience of CBM-pa in the target population. Patient opinion supports further development and testing of CBM-pa as a possible adjunct treatment for paranoia.

Acceptability and Co‐Development of an Online Cognitive Bias Modification Intervention for Emerging Adults With Hazardous Alcohol Use and Social Anxiety: A Mixed Methods Study

“…Given CBMs low face validity, both groups expressed a desire to better understand how CBM training works and how doing the training may help reduce alcohol use and improve social anxiety. This echoes the feedback provided in previous CBM acceptability studies (Beard et al, 2012; Leung et al, 2019). Provision of a compelling rationale at the outset of the program is important for initial buy‐in and setting expectations about the purpose and nature of the intervention (e.g., computerized, repetitive training; Beard and Peckham, 2020).…”

“…have potential utility for service providers and emerging adults alike. Consistent with prior research on the acceptability of CBM (Beard et al, 2019;Leung et al, 2019), responses from both groups were generally positive, with most participants describing the beta intervention as easy to complete and straightforward. Emerging adults rated the usability of the program more positively than did the service providers, with ratings equivalent to "B-grade" (M = 74.0) and "Cgrade" (M = 68.4), respectively.…”

“…Finally, numerous studies have shown that existing CBM programs are generally deemed acceptable and feasible add‐on treatments by clients and clinicians alike (Beard et al, 2012; Leung et al, 2019; Rozenman et al, 2011). IBM studies in particular have been reported as acceptable with regard to their perceived helpfulness, personal relevance, user‐friendliness, credibility, ease of use, simplicity, and esthetic appearance (Beard, 2011; Beard et al, 2020; Beard et al, 2019).…”

A Web-Based Cognitive Bias Modification Intervention (Re-train Your Brain) for Emerging Adults With Co-occurring Social Anxiety and Hazardous Alcohol Use: Protocol for a Multiarm Randomized Controlled Pilot Trial

“…In line with this, a study was conducted to evaluate the acceptability of a beta version of the Re-train Your Brain program according to the perspectives of clinicians and emerging adults with hazardous drinking and heightened social anxiety [ 51 ]. The results indicated that the ApBM+IBM intervention was an acceptable adjunct to traditional evidence-based treatments with potential clinical utility, a finding that mirrors previous CBM acceptability studies [ 52 , 53 ]. To enhance engagement, clinical utility, and intrinsic motivation to complete the training, clinicians and emerging adults suggested that the program should include a psychoeducational and motivation enhancement-type module before the first training session.…”

The experience of psychosis and recovery from consumers' perspectives: An integrative literature review

“…The eleven primary studies were conducted in different countries. In the United States of America, there were three articles (Barut et al., 2016; Blakeman et al., 2013; Jenkins & Carpenter‐Song, 2009), followed by two in each of the United Kingdom (Kaar et al., 2019; Leung et al., 2019) and South Africa (Nxumalo Ngubane et al., 2019; de Wet et al., 2015), then one study in each country: Australia (Henderson & Cock, 2015), Poland (Nowak et al., 2017), Israel (Mazor & Doron, 2011) and Spain (Saavedra, 2009).…”