Social Recovery Therapy in improving activity and social outcomes in early psychosis: Current evidence and longer term outcomes

David Fowler,Jo Hodgekins,Paul French

doi:10.1016/j.schres.2017.10.006

Abstract

BackgroundSocial Recovery Therapy (SRT) is a cognitive behavioural therapy which targets young people with early psychosis who have complex problems associated with severe social disability. This paper provides a narrative overview of current evidence for SRT and reports new data on a 2year follow-up of participants recruited into the Improving Social Recovery in Early Psychosis (ISREP) trial. MethodIn the ISREP study 50 participants (86%) were followed up at 2years, 15months post treatment. The primary outcome was engagement in paid work, assessed using the Time Use Survey. Engagement in education and voluntary work were also assessed. In addition, the Positive and Negative Syndrome Scales (PANSS) and the Beck Hopelessness Scale (BHS) were administered. Results25% of individuals with non-affective psychosis in the treatment group had engaged in paid work at some point in the year following the end of therapy, compared with none of the control group. Data from the PANSS and BHS suggested no worsening of symptoms and an indication that gains in hope were maintained over the 15month period following the end of therapy. ConclusionSocial Recovery Therapy is a promising psychological intervention which may improve social recovery in individuals with early psychosis. The new data reported in this paper shows evidence of gains in engagement in paid employment outcomes that persisted 15months beyond the period of active intervention.

Highlights

Studies suggest that b50% of people with non-affective psychosis achieve a social recovery (Hafner and an der Heiden, 1999; Harrison et al, 1996), and only 10–20% of people return to competitive employment despite
Primary outcome The presence of paid work, education, and voluntary work occurring at any point in the year following the end of therapy was screened for using the Time Use Survey (Hodgekins et al, 2015b; Gershuny, 2011)
Work, education, and voluntary work were coded as being either present or absent in the year following the end of the intervention period

Summary

Introduction

Social recovery can be defined in terms of engagement in activities within occupational and interpersonal domains (Hodgekins et al, 2015a, 2015b) This may include work, education, valued social activities, and relationships with others. This paper provides a narrative overview of current evidence for SRT and reports new data on a 2 year follow-up of participants recruited into the Improving Social Recovery in Early Psychosis (ISREP) trial. Results: 25% of individuals with non-affective psychosis in the treatment group had engaged in paid work at some point in the year following the end of therapy, compared with none of the control group. The new data reported in this paper shows evidence of gains in engagement in paid employment outcomes that persisted 15 months beyond the period of active intervention

Methods

Results

Discussion

Conclusion