WELLFOCUS PPT: modifying positive psychotherapy for psychosis

Positive psychotherapy (PPT) is an established psychological intervention initially validated with people experiencing symptoms of depression. PPT is a positive psychology intervention, an academic discipline which has developed somewhat separately from psychotherapy and focuses on amplifying wellbeing rather than ameliorating deficit. The processes targeted in PPT (e.g. strengths, forgiveness, gratitude, savouring) are not emphasised in traditional psychotherapy approaches to psychosis. The goal in modifying PPT is to develop a new clinical approach to helping people experiencing psychosis. An evidence-based theoretical framework was therefore used to modify 14-session standard PPT into a manualised intervention, called WELLFOCUS PPT, which aims to improve wellbeing for people with psychosis. Informed by a systematic review and qualitative research, modification was undertaken in four stages: qualitative study, expert consultation, manualisation and stake-holder review. The resulting WELLFOCUS PPT is a theory-based 11-session manualised group therapy

Therapist self-disclosure in positive psychotherapy for psychosis

© 2020, British Psychological Society. All rights reserved. Setting boundaries is common in therapist self-disclosure. This qualitative study examined attitudes and experiences of therapists towards self-disclosure during a positive psychotherapy for psychosis research trial. Participants reported therapeutic benefits but discussed challenges with retaining personal privacy while ensuring their authenticity

Using Augmented Reality Toward Improving Social Skills:Scoping Review

BackgroundAugmented reality (AR) has emerged as a promising technology in educational settings owing to its engaging nature. However, apart from applications aimed at the autism spectrum disorder population, the potential of AR in social-emotional learning has received less attention. ObjectiveThis scoping review aims to map the range of AR applications that improve social skills and map the characteristics of such applications. MethodsIn total, 2 independent researchers screened 2748 records derived from 3 databases in December 2021—PubMed, IEEE Xplore, and ACM Guide to Computing Literature. In addition, the reference lists of all the included records and existing reviews were screened. Records that had developed a prototype with the main outcome of improving social skills were included in the scoping review. Included records were narratively described for their content regarding AR and social skills, their target populations, and their outcomes. Evaluation studies were assessed for methodological quality. ResultsA total of 17 records met the inclusion criteria for this study. Overall, 10 records describe applications for children with autism, primarily teaching about reading emotions in facial expressions; 7 records describe applications for a general population, targeting both children and adults, with a diverse range of outcome goals. The methodological quality of evaluation studies was found to be weak. ConclusionsMost applications are designed to be used alone, although AR is well suited to facilitating real-world interactions during a digital experience, including interactions with other people. Therefore, future AR applications could endorse social skills in a general population in more complex group settings

Evaluation of a positive psychotherapy group intervention for people with psychosis: pilot randomised controlled trial

Aims. Third-wave psychological interventions have gained relevance in mental health service provision but their application to people with psychosis is in its infancy and interventions targeting wellbeing in psychosis are scarce. This study tested the feasibility and preliminary effectiveness of positive psychotherapy adapted for people with psychosis (WELLFOCUS PPT) to improve wellbeing. Methods. WELLFOCUS PPT was tested as an 11-week group intervention in a convenience sample of people with psychosis in a single centre randomised controlled trial (ISRCTN04199273) involving 94 people with psychosis. Patients were individually randomised in blocks to receive either WELLFOCUS PPT in addition to treatment as usual (TAU), or TAU only. Assessments took place before randomisation and after the therapy. The primary outcome was wellbeing (Warwick-Edinburgh Mental Well-Being Scale, WEMWBS). Secondary outcomes included symptoms (Brief Psychiatric Rating Scale), depression (Short Depression-Happiness Scale), self-esteem, empowerment, hope, sense of coherence, savouring beliefs and functioning, as well as two alternative measures of wellbeing (the Positive Psychotherapy Inventory and Quality of Life). Intention-to-treat analysis was performed. This involved calculating crude changes and paired-sample t-tests for all variables, as well as ANCOVA and Complier Average Causal Effect (CACE) Analysis to estimate the main effect of group on all outcomes. Results. The intervention and trial procedures proved feasible and well accepted. Crude changes between baseline and follow-up showed a significant improvement in the intervention group for wellbeing according to all three concepts assessed (i.e., WEMWBS, Positive Psychotherapy Inventory and Quality of Life), as well as for symptoms, depression, hope, self-esteem and sense of coherence. No significant changes were observed in the control group. ANCOVA showed no main effect on wellbeing according to the primary outcome scale (WEMWBS) but significant effects on symptoms (p = 0.006, ES = 0.42), depression (p = 0.03, ES = 0.38) and wellbeing according to the Positive Psychotherapy Inventory (p = 0.02, ES = 0.30). Secondary analysis adapting for therapy group further improved the results for symptom reduction (p = 0.004, ES = 0.43) and depression (p = 0.03, ES = 0.41) but did not lead to any more outcomes falling below the p = 0.05 significance level. CACE analysis showed a non-significant positive association between the intervention and WEMWBS scores at follow-up (b = 0.21, z = 0.9, p = 0.4). Conclusions. This study provides initial evidence on the feasibility of WELLFOCUS PPT in people with psychosis, positively affecting symptoms and depression. However, more work is needed to optimise its effectiveness. Future research might evaluate positive psychotherapy as a treatment for comorbid depression in psychosis, and consider alternative measurements of wellbeing