‘It was me answering my own questions’: Experiences of method of levels therapy amongst people with first‐episode psychosis

Abstract

In this study, we aimed to understand how people with first‐episode psychosis experienced a transdiagnostic cognitive therapy called method of levels (MOL). Semistructured interviews were conducted with 12 individuals who were participants of a feasibility randomized controlled trial of MOL for first‐episode psychosis. Interviews were analysed using thematic analysis. Four superordinate themes were identified: ‘The therapist's approach’; ‘I was in control’; ‘Thinking and talking’; and ‘Looking at problems from a different perspective’. Our findings suggest that therapy was experienced as most helpful when participants perceived themselves to have control over the process of therapy, could explore and express a wide range of difficulties, and were able to generate new perspectives on their problems. MOL and its associated system of client‐led appointment scheduling were predominantly perceived to be helpful and appear suitable for further testing in a larger clinical trial.

A qualitative analysis of young people's experiences of receiving a novel, client‐led, psychological therapy in school

“…Method of Levels has been successfully used with adults experiencing psychological distress in a variety of settings (Carey & Mullan, , ; Carey & Spratt, ). A recent qualitative study exploring how individuals with first‐episode psychosis experience MOL found that therapy was perceived most helpful when individuals had control over the therapeutic process which gave them the opportunity to explore difficulties and generate new solutions (Griffiths et al, ). However, no studies with young people have been conducted.…”

Method of levels therapy for first‐episode psychosis: The feasibility randomized controlled Next Level trial

“…None of the participants in the MOL group reported that they stopped attending therapy because it was not meeting their needs, which suggests the intervention is acceptable to people experiencing FEP. This is supported by data collected using the Session Rating Scale (Duncan et al, ) and the findings of the nested qualitative study (Griffiths et al, ). Having control over therapy, being able to speak openly about problems, and having the opportunity to develop new perspectives were particularly valued by participants receiving MOL.…”

“…A nested qualitative study was also undertaken to investigate participants’ experiences of trial participation, the MOL intervention, and the service user‐led appointment booking system. The results of this qualitative study have been reported separately (Griffiths et al, ). The trial was prospectively registered with the ISRCTN registry (ISRCTN13359355).…”

“…The current study, called “Next Level,” aimed to establish the feasibility and acceptability of MOL for people experiencing FEP and determine its suitability for further testing in a clinical trial. As part of the Next Level study, a nested qualitative study exploring participants’ experiences of receiving MOL was conducted (Griffiths et al, ). No previous studies had investigated the use of MOL for FEP, so a feasibility trial was required before a larger effectiveness trial could be justified.…”

Why Do We Need Computational Models of Psychological Change and Recovery, and How Should They Be Designed and Tested?

“…One successful example of a way to enhance control is to provide patients with the opportunity to determine the timing, appointment scheduling, session length, and duration of their psychological therapy (38). Further successful examples include providing people with the control of the topic of each therapy session (39), or providing them with technology to exert moment-by-moment control of their level of exposure during therapy (40).…”