The service user experience of SlowMo therapy: A co‐produced thematic analysis of service users’ subjective experience

Abstract

Objectives SlowMo is the first blended digital therapy for paranoia, showing significant small‐moderate reductions in paranoia in a recent large‐scale randomized controlled trial (RCT). This study explored the subjective service‐user experience of the SlowMo therapy content and design; the experience of the blended therapy approach, including the triangle of the therapeutic alliance; and the experience of the digital aspects of the intervention. Design Qualitative co‐produced sub‐study of an RCT. Methods Participants were 22 adult service users with schizophrenia‐spectrum psychosis and persistent distressing paranoia, who completed at least one SlowMo therapy session and a 24‐week follow‐up, at one of 3 sites in Oxford, London, and Sussex, UK. They were interviewed by peer researchers, using a topic guide co‐produced by the Patient and Public Involvement (PPI) team. The transcribed data were analysed thematically. Multiple coding and triangulation, and lay peer researcher validation were used to reach a consensus on the final theme structure. Results Six core themes were identified: (i) starting the SlowMo journey; (ii) the central role of the supportive therapist; (iii) slowing things down; (iv) value and learning from social connections; (v) approaches and challenges of technology; and (vi) improvements in paranoia and well‐being. Conclusions For these service users, slowing down for a moment was helpful, and integrated into thinking over time. Learning from social connections reflected reduced isolation, and enhanced learning through videos, vignettes, and peers. The central role of the supportive therapist and the triangle of alliance between service user, therapist, and digital platform were effective in promoting positive therapeutic outcomes.

Digital Mental Health for Schizophrenia and Other Severe Mental Illnesses: An International Consensus on Current Challenges and Potential Solutions

“…This was the first digitally supported therapy for paranoia to demonstrate efficacy (improved effect size compared to conventional CBTp was achieved in half of the minimum number of recommended sessions [ 65 ]), and the mechanism of change. A process evaluation of therapy experience demonstrated high rates of therapy uptake and adherence [ 66 ], a coproduced qualitative interview study supported the user experience and mechanism of change [ 67 ], and a user experience study showed that SlowMo bridged the “digital divide” as poorer digital literacy in Black people and older people did not translate to the user experience of SlowMo [ 19 ].…”

A systematic review of users experiences of using digital interventions within psychosis: a thematic synthesis of qualitative research

“…Fifteen out of the nineteen studies were rated as high quality, with a score of 9 or above [12,[33][34][35][36][37][38][39][40][41][42][43][44][45][46]. The rest of the studies were rated as moderate quality, scoring either 7 or 8 [14,[47][48][49].…”

“…The item that was scored most poorly across the included studies was in relation to reflexivity and bias. Only seven out of the nineteen studies had a clear reflexivity statement or explanation of the researchers' relationship with the participants [12,33,34,39,42,44,45].…”

“…Smartphone usage among people with psychosis is now at equivalent levels to the general population, with greater interest in developing digital interventions targeting psychosis [7][8][9]. Previous research has shown that digital interventions for people with psychosis are acceptable and can result in benefits including increased access to services, reduced stigma around receiving mental health treatment, and accommodating difficulties arising from cognitive impairments and/or low levels of motivation [10][11][12][13][14][15][16]. However, concerns about security and privacy when accessing support digitally have also been highlighted [17].…”

Public involvement in chronic respiratory diseases research: A qualitative study of patients', carers' and citizens' perspectives

“…27 Participants' expectations were mainly related to increasing their health literacy, sense of belonging and the positive impact on the research, which have been previously described in other PPI initiatives. 28,29 Nevertheless, we need to consider that these expectations are voiced by participants without previous experience as research partners. Thus, it is advisable to have an ongoing assessment of expectations as network members gain research experience.…”