WELLFOCUS PPT – modified positive psychotherapy to improve well-being in psychosis: study protocol for a pilot randomised controlled trial

Abstract

BackgroundThe promotion of well-being is an important goal of recovery oriented mental health services. No structured, evidence-based intervention exists that aims to increase the well-being in people with severe mental illness such as psychosis. Positive psychotherapy (PPT) is a promising intervention for this goal. Standard PPT was adapted for use with people with psychosis in the UK following the Medical Research Council framework for developing and testing complex interventions, resulting in the WELLFOCUS Model describing the intended impact of WELLFOCUS PPT. This study aims to test the WELLFOCUS Model, by piloting the intervention, trial processes, and evaluation strategy.Methods/DesignThis study is a non-blinded pragmatic pilot RCT comparing WELLFOCUS PPT provided as an 11-session group therapy in addition to treatment as usual to treatment as usual alone. Inclusion criteria are adults (aged 18–65 years) with a main diagnosis of psychosis who use mental health services. A target sample of 80 service users with psychosis are recruited from mental health services across the South London and Maudsley NHS Foundation Trust. Participants are randomised in blocks to the intervention and control group. WELLFOCUS PPT is provided to groups by specifically trained and supervised local therapists and members of the research team. Assessments are conducted before randomisation and after the group intervention. The primary outcome measure is well-being assessed by the Warwick-Edinburgh Mental Well-being Scale. Secondary outcomes include good feelings, symptom relief, connectedness, hope, self-worth, empowerment, and meaning. Process evaluation using data collected during the group intervention, post-intervention individual interviews and focus groups with participants, and interviews with trial therapists will complement quantitative outcome data.DiscussionThis study will provide data on the feasibility of the intervention and identify necessary adaptations. It will allow optimisation of trial processes and inform the evaluation strategy, including sample size calculation, for a future definitive RCT.Trial registrationCurrent Controlled Trials ISRCTN04199273 – WELLFOCUS study: an intervention to improve well-being in people with psychosis, Date registered: 27 March 2013, first participant randomised on 26 April 2013.

Mental Health Service User Experience of Positive Psychotherapy

“…Data were collected as part of a larger randomized controlled pilot trial testing WELLFOCUS PPT (Schrank, Riches, et al, 2014). Inclusion criteria for the trial were age 18-65 years, clinical diagnosis of psychosis, sufficient conversational English, and ability to provide informed consent.…”

“…An adaptation of standard 14-session PPT (WELLFOCUS PPT) has been developed for people with psychosis Schrank, Riches, et al, 2013) and tested in a randomized controlled trial (Schrank, Riches, et al, 2014), which was found to improve specific aspects of well-being, including overall symptomatology and depression. The aim of this study was to investigate service user experience of therapy components in WELLFOCUS PPT.…”

Positive psychotherapy for depression and self‐efficacy in undergraduate nursing students: A randomized, controlled trial

“…Schrank et al . () used PPT in people with psychosis, and found that it not only improved specific aspects of mental health, but also reduced symptoms of depression. Compared to standard therapeutic methods and antidepressants, PPT had a better long‐term effect on alleviating depression and increasing happiness (Asqharipoor et al .…”

Intervenciones clínicas positivas: ¿Por qué son importantes y cómo funcionan?

“…The intervention was well accepted by the patients and associated with improvements in psychological well-being, psychological recovery, self-esteem, and psychiatric symptoms. Recently, PPT was evaluated in a randomized controlled trial for people with psychosis (Schrank et al, 2014). In an iterative process with experts an adapted version of PPT was developed, called WELLFOCUS PPT (Riches, Schrank, Rashid, & Slade, 2015).…”