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

BACKGROUND: The 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/DESIGN: This 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. DISCUSSION: This 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 REGISTRATION: Current 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

From therapy to daily life of a depressed adolescent: Crossing psychopathology and optimal functioning

First published online: 30 November 2017Recently, scientific literature has seen significant development and evaluation of several positive psychology interventions. However, there are still lacking studies that evaluate the efficacy of this type of interventions in clinically depressed adolescents. This paper aims to demonstrate the preliminary results of a new therapy implemented to a 14-year-old female adolescent diagnosed with Major Depressive Disorder: the Optimal Functioning Therapy for Adolescent. This therapy seeks to promote adolescents’ optimal functioning by reducing depressive symptoms and increasing well-being. The innovation of this therapy lies in the integration of techniques from Cognitive-Behavioral Therapy and Positive Psychology Interventions. The assessment of this therapy was made using retrospective and real-time or ecological measures (Experience Sampling Method – Csikszentmihalyi and Larson in Journal of Nervous and Mental Disease, 175, 526–536, 1987) in three moments: baseline; post-intervention; and 4-month follow-up. Retrospective results showed improvement in positive trait characteristics and elimination of depressive symptoms maintained until follow-up. Real-time results showed the benefits of the therapy on the participant’s daily life regarding external contexts (increased engagement and diversification of activities, places, and companies) and state characteristics (increase in positive mood and self-satisfaction, and a decrease in the negative mood), maintained until follow-up. The Optimal Functioning Therapy for Adolescents contributed to the treatment of Major Depressive Disorder and optimal functioning enhancement.(undefined)info:eu-repo/semantics/publishedVersio