Exploring service user perspectives of behavioural family therapy in early intervention in psychosis.

AIMS: Family intervention (FI) is recommended in national guidance to be offered to all service users accessing an early intervention in psychosis (EIP) team, due to the consistent evidence base in reducing relapse and rehospitalisation rates. However, FI implementation is poor nationally. Although barriers have been identified at the level of staff member and the organisation, there is a paucity of research identifying service user perspectives. METHODS: A qualitative questionnaire design was used to explore service user perspectives of behavioural family therapy (BFT) within a specialist EIP service in northwest England. RESULTS: Most participants contacted reported they lacked knowledge and understanding of BFT, with 54% reporting that this intervention had not been offered to them. This finding was unexpected and is inconsistent with the offer of BFT documentation in their clinical notes. Reasons for accepting BFT included to increase understanding of family members and for them to also be supported. Reasons for declining BFT included a preference for one-to-one interventions and not wanting family involved in their care. CONCLUSIONS: National guidance on FI for psychosis is not reliably being translated to clinical practice, with many participants reporting that they were not offered this intervention. A key factor in accepting or declining an offer of BFT appeared to be whether participants wanted family members to be involved in their care. A lack of understanding of the BFT approach was evident, it is recommended that the offer of FI in psychosis is improved for service users to make an informed decision.

Exploring the Role of Mental Imagery in the Experience of Self-injury: An Interpretative Phenomenological Analysis.

BACKGROUND: Research has implicated causal, mediating and meaningful roles for mental imagery in the experience of psychological distress, including self-injury. AIMS: The present study aimed to further the understanding of this relationship through exploring the lived experiences of mental imagery from the perspective of those who self-injure. METHOD: This study employed an inductive qualitative design using semi-structured interviews and Interpretative Phenomenological Analysis (IPA). Ten participants were recruited from universities in North West England. RESULTS: Three main themes were identified from the analysis: (i) The origins and precipitants of self-injurious imagery; (ii) What it is like to experience self-injurious imagery; and (iii) The meaning and interpretation of self-injurious imagery. CONCLUSIONS: The study findings indicate that mental imagery is an important experience for those who self-injure. Clinical and research implications of the findings are discussed.

New approaches towards chronic pain: patient experiences of a solution-focused pain management programme.

UNLABELLED: Research has suggested that Solution-Focused Brief Therapy (SFBT) may be effective in facilitating meaningful change for those living with chronic pain. This study aimed to further this understanding through exploring the experiences of people living with chronic pain, who had attended an 8-week solution-focused pain management programme. The design of this study was conducted in consultation with a service-user advisory group, and employed a qualitative and interpretative design rooted in critical community psychology, participatory research frameworks and emancipatory disability research. Five participants opted-in to the study following an opportunity sampling method of persons who had attended a programme in the last 18 months. Interviews were transcribed verbatim and analysed using inductive thematic analysis. Five main themes were identified: 'Accessing the pain management programme', 'A solution-focused group', 'The solution-focused clinician', 'Solutions and changes' and 'Challenges and improvements'. Clinical and research implications of the findings are discussed. SUMMARY POINTS: There has been an international proliferation of pain management programmes (PMPs) aimed at helping those with chronic pain to live well, despite an unremitting condition.Arguably, the most popular psychological approaches used within PMPs are informed by cognitive behavioural therapy (CBT).Despite a supportive evidence base for psychological approaches in pain management, there is a recognised need for further research into alternative approaches and their effectiveness.Emerging research and policy recommendations are beginning to value the expertise of those living with chronic conditions, particularly how these perspectives can be used to develop effective treatments and services.SFBT is an approach aimed at achieving a patient's goals or 'preferred future' through identifying and utilising their expertise. SFBT may have significant efficacy in helping those with chronic conditions to live improved, meaningful lives.