Abstract
There is a wealth of research into relapse prevention in psychosis; however, specific research into the effectiveness of short-term, self-management strategies aimed to prevent relapse is lacking. This pilot study aimed to evaluate the effects of Sorensen’s ‘Relapse Prevention in Schizophrenia and Other Psychoses’ manual-based therapy (Sorensen, 2006b) with 11 participants in one UK National Health Service Trust. The intervention was delivered over four sessions and interviews were conducted pre and post intervention. The effect of the intervention on measures of hopelessness, perceived control over internal states, and satisfaction were recorded using validated questionnaires at one week, one month and two months follow-up, supported by measures taken from visual analogue scales. Data analysis revealed significant improvements on hopelessness, perceived control over internal states, and satisfaction at one week follow-up, although these results were not maintained at one and two months follow-up. Additionally, the attrition rate meant that results lacked statistical power at one and two months follow-up. The study also considered the clinical significance of the research findings with the Jacobson-Truax (Jacobson & Truax, 1991) method for measuring reliable change. A substantial number of clients attained clinically significant changes with regards to hopelessness and perceived control over internal states. Future research is required in order to evaluate the use of self-management strategies to prevent relapse. It would be valuable to repeat the current study with the additional use of booster sessions in order to assess whether the positive impacts on hopelessness and perceived control over illness can be maintained at the longer term follow up.
Highlights
The term psychosis is understood as a cluster of disorders, characterised by psychotic symptoms that alter a person’s perception, thoughts, affect, and behaviour
Satisfaction and Perceived Usefulness of the Intervention The results reported above justify the conclusion that the relapse prevention intervention can effect positive change in hopelessness and perceived control over internal states, but in order to be a useful strategy in daily NHS practice the intervention must be resistant to high dropout rates
The confidence intervals at 1 month and 2 month follow-up are comparatively large and further data collection is required for followup
Summary
The term psychosis is understood as a cluster of disorders, characterised by psychotic symptoms that alter a person’s perception, thoughts, affect, and behaviour. The stress-vulnerability model (Zubin & Spring, 1977) suggests that individuals have different levels of vulnerability or predisposition to certain symptoms, difficulties or illnesses (biological or psychological). This vulnerability interacts with the level of stress to which the individual is exposed, potentially leading to a psychotic episode. The stress-vulnerability hypothesis and emerging support for the impact of environmental and social factors on the disorder illustrates the need for a multimodal intervention strategy in order to optimise treatment (Hultman, Wieselgren, & Öhman, 1997)
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