Abstract
BackgroundEvidence shows that internet-based self-help interventions are effective in reducing symptoms for a wide range of mental disorders. To date, online interventions treating psychotic disorders have been scarce, even though psychosis is among the most burdensome disorders worldwide. Furthermore, the implementation of cognitive-behavioral therapy (CBT) for psychosis in routine health care is challenging. Internet-based interventions could narrow this treatment gap. Thus, a comprehensive CBT-based online self-help intervention for people with psychosis has been developed. The aim of this study is the evaluation of the feasibility and efficacy of the intervention compared with a waiting list control group.MethodsThe intervention includes modules on delusion, voice hearing, social competence, mindfulness, and seven other domains. Participants are guided through the program by a personal moderator. Usage can be amended by an optional smartphone app. In this randomized controlled trial, participants are allocated to a waiting list or an intervention of eight weeks. Change in positive psychotic symptoms of both groups will be compared (primary outcome) and predictors of treatment effects will be assessed.DiscussionTo our knowledge, this project is one of the first large-scale investigations of an internet-based intervention for people with psychosis. It may thus be a further step to broaden treatment options for people suffering from this disorder.Trial registrationNCT02974400 (clinicaltrials.gov), date of registration: November 28th 2016.
Highlights
Reflect on thoughts, feelings and behavior to understand and decrease the symptom burden.Feelings of ThreatReview the effects of paranoia on individual goals and needs
National regulations such as the United Kingdom National Institute for Health and Care Excellence (NICE) guideline recommend that cognitive behavioral therapy for psychosis (CBTp) should be offered to every person with psychotic symptoms [31]
We developed a web-based program that is comprehensive in many respects: The program is based on cognitive-behavioral therapy (CBT) and includes elements from its third wave, ACT and Metacognitive Training for psychosis (MCT) [34, 36]
Summary
Feelings and behavior to understand and decrease the symptom burden.Feelings of ThreatReview the effects of paranoia on individual goals and needs. Evidence shows that internet-based self-help interventions are effective in reducing symptoms for a wide range of mental disorders. Schizophrenia and other psychotic disorders are severe mental disorders with heterogeneous symptom profiles encompassing positive symptoms such as persecutory delusions and auditory verbal hallucinations as well as negative symptoms such as social isolation and avolition [1] They are accompanied by neuropsychological impairments in attention, memory, and executive functioning [2,3,4,5,6]. In regular mental health care, the effectiveness of CBTp has been asserted [30], and neurocognitive deficits, comorbidity and poorer functioning pose no barrier to improvement during CBTp [28] National regulations such as the United Kingdom National Institute for Health and Care Excellence (NICE) guideline recommend that CBTp should be offered to every person with psychotic symptoms [31]
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