Single‐session Comprehend, Cope, and Connect intervention in acute and crisis psychology: A feasibility and acceptability study

Abstract

Comprehend, Cope, and Connect (CCC) is a third‐wave cognitive behavioural approach developed for acute mental health services. The aim of this study was to assess feasibility and acceptability of a newly developed, manualized single‐session CCC intervention delivered face‐to‐face with service users in acute and crisis psychology services in South London. The study adopted a within‐subjects pre‐post‐test design. Participants (N = 23) were recruited from five acute psychiatric wards and a crisis resolution home treatment team. Service users had a range of diagnoses of complex and severe mental health conditions, in particular mood, personality, and psychotic disorders. Feasibility data were gathered for number of times the CCC formulation was accepted, duration of CCC intervention, clinician adherence to manualised protocol, and frequency of goal‐based activity completion. Acceptability data on pre‐ and post‐CCC mood and post‐CCC helpfulness were self‐reported by participants. Findings indicated a significant increase in positive mood (large effect) and moderate–high helpfulness rating postintervention. Most participants reported goal‐based activity completion. There was high fidelity to the protocol, high percentage of acceptance of the formulation and formulation components completed, and frequent single‐session completion. Single‐session CCC appears feasible and acceptable in acute and crisis psychology services and yields formulation‐driven goal‐based activities intended to stabilize mental health crisis. High fidelity to formulation protocol suggests broader applications for single‐session CCC, for example, to support clinical staff to manage crisis situations in their work environment or to train nonpsychologist clinicians to deliver the intervention for service users. A randomized controlled trial of single‐session CCC would increase validity and generalisability of findings.

A study on the feasibility of delivering a psychologically informed ward‐based intervention on an acute mental health ward

“…These types of systems are known to suffer from a range of limitations, and the presence of incomplete records has been well-documented (Chan et al, 2010;Thiru et al, 2003;Weiskopf & Weng, 2013). The patient attrition rate of 70% observed in this study was twice the rate of other studies with similar population samples (Bullock et al, 2020;Haddock et al, 2009;Heriot-Maitland et al, 2014). As evidenced by the changes in the MBI scores, there was a reduction in emotional exhaustion and depersonalization and an increase in personal accomplishment among ward staff at follow-up.…”

“…Similarly, a recent study by Bullock et al (2020) found that a single session of the Comprehend, Cope, and Connect intervention delivered on five acute mental health wards was feasible and acceptable by staff and patients. However, to enhance the evidence base on effective therapies within these settings, both Paterson et al (2019) and Bullock et al (2020) concluded that larger research trials with feasible interventions and trial designs are needed. The paper outlines a study exploring the feasibility of (i) delivering a psychological service model that involved a number of key components, including formulation, training staff to deliver low‐intensity interventions with service users, and a psychologist offering interventions to patients; (ii) the feasibility of recruiting and retaining staff and patient participants; and (iii) the feasibility of collating and amalgamating ward‐level serious incidents across the two wards in study.…”

“…However, the study found that although feasible to deliver individual psychology sessions with patients, it was difficult to carry out nurse-led group psychology sessions. Similarly, a recent study by Bullock et al (2020) found that a single session of the Comprehend, Cope, and Connect intervention delivered on five acute mental health wards was feasible and acceptable by staff and patients. However, to enhance the evidence base on effective therapies within these settings, both Paterson et al (2019) and Bullock et al (2020)…”

Impact on staff attitudes of brief personality disorder training for acute psychiatric wards

“…As brief, short-term interventions have been shown to work well in this setting (Bullock et al , 2021; Riches et al , 2021), the aim of the present study was to develop and evaluate a brief training intervention for mental health professionals and to explore the impact of it on staff attitudes towards service users with a diagnosis of “personality disorder” in an acute psychiatric setting. It was hypothesised that the training would lead to increased understanding and improve attitudes.…”

Culture Free CBT for Diverse Groups

“…CCC was first evaluated within Acute Mental Health services [47][48][49][50], and developed for delivery in a primary care, Increasing Access to Psychological Therapies (IAPT) service, for complex cases [51]. Within primary care, the programme consisted of four individual, collaboratively arrived at, emotion and trauma-focused formulation sessions, followed by a 12 week group, skills based, intervention, targeting emotion management and behaviour change.…”