A Pilot Investigation of the Use of Positive Psychotherapy for People with a First Episode of Psychosis

Abstract

Objective: Mental health services are placing a greater emphasis on wellbeing and recovery. Services are also prioritizing the early intervention for people with psychosis in order to support mental health and to reduce the negative impact on the person’s life. Positive Psychotherapy is the therapy that directly cultivates subjective wellbeing and it also aligns with attaining personal recovery. Method: A pilot single case experimental design investigated the use of Positive Psychotherapy for people with a first episode of psychosis. Five people (2 males, 3 females) aged between 20 and 47 years, were recruited from the North Dublin Mental Health Services. Results: Positive Psychotherapy was found to be an acceptable therapy with all of the participants completing the intervention. Some improvements were noted within the daily recording of subjective wellbeing, yet the effect of the intervention was not replicated throughout participants. However, there were differences in relation to how people with higher and lower levels of distress experience Positive Psychotherapy. The findings on the standardized wellbeing measures indicate that people recovering from psychosis can attain subjective wellbeing and to the same level as that recorded within the general population. There was clearly a greater drop in participants’ level of distress than an increase in wellbeing on the standardized measures. It may therefore be that distress and wellbeing are distinctive constructs. Reliable change occurred within more people on the clinical measure of distress than on the wellbeing measures, with clinically significant change occurring within most participants. All of the participants’ level of functioning also increased following the intervention. It is recommended for future interventions to align people presenting with similar levels of: distress, wellbeing and features of psychosis. It is also suggested to investigate the links or otherwise between the constructs and the mechanisms underpinning the therapy. Conclusion: There is initial evidence that Positive Psychotherapy is beneficial to the mental health of people recovering from psychosis. This is particularly evident on the standardized clinical measure of distress and in terms of increasing people’s levels of functioning. However, further refined research is clearly warranted.