Background and aims
Social anxiety is common in people with psychosis. Recent evidence suggests that cognitive behavioural interventions can be used with this population to reduce distress and increase functioning. Imagery rescripting is effective for a range of psychological problems including social anxiety. This study aimed to investigate whether imagery rescripting is effective for social anxiety in people with psychosis.
Method
A single case series, multiple baseline design was used. Ten participants were recruited from Early Intervention in Psychosis (EIP) and Integrated Delivery Team (IDT) services in Norfolk and Suffolk. The intervention was replicated from previous work in the social anxiety field (Wild et al., 2008; Wild & Clark, 2011). Throughout the study participants completed measures related to social anxiety, beliefs, memory and imagery, psychotic symptoms, depression, social functioning and quality of life. Each participant attended seven sessions including a one month follow-up assessment. Data were analysed using visual inspection and the calculation of reliable and clinical change. Exploratory group statistics and effect sizes were also calculated.
Results
Five participants achieved reliable and clinical change in social anxiety and were classified as ‘recovered’ (Wise, 2004). Improvements in belief, memory and imagery ratings were observed for most participants following imagery rescripting. Psychotic symptoms, depression, social functioning and quality of life remained largely stable. Those who didn’t recover had more complex needs or comorbid difficulties. Group
Imagery rescripting for social anxiety in psychosis D. Heavens
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analyses revealed significant improvements and medium to large effect sizes. However, this should be interpreted with caution due to the small sample size.
Conclusion
The study offers some support for the use of imagery rescripting for social anxiety in people with psychosis. Those with less complex presentations are likely to benefit most and it may offer a brief yet effective intervention for these individuals. Those with complex difficulties may require longer and more intensive input
