Introduction
Psychosis and Recovery
Narrative Approaches to Challenge Stigma in Recovery
Narratives in Late-Onset Psychosis
Narrative Enhancement and Cognitive Therapy (NECT)
Adaptation of NECT for LOP in the United Kingdom
Aim and Research Questions
Methods
Research Design
Phase One: Development and Adaptation
Phase Two: Feasibility
Objective One: Recruitment Capability and Sample Characteristics
Objective Two: Data Collection and Outcome Measures
Objective Three: Acceptability of Intervention
Objective Four: Feasibility of the Intervention
Objective Five: Evaluation of Participant Response to Intervention
Ethics Approval
Results
Phase One: Development and Adaptation
Phase Two: Feasibility
Objective 1: Recruitment Capability and Sample Characteristics
Objective 2: Data Collection and Outcome Measures
Objective 3: Acceptability of Intervention
Objective 4: Feasibility of the Intervention
Session | Topic and session summary | Attendance ratio (attenders: non-attenders) | Session satisfaction (SRS total: mean, range) |
---|---|---|---|
1 | Introduction to group Orientation to group aims and rules. Discussions on mental health, employment and stigma | 4:0 | 31 (23-38) |
2 | Identity and labels Continued discussions from session 1. Exercise on an identity that was important for participants. Discussions on employment, stigma and negative emotions | 4:0 | 34 (31-38) |
3 | Exercise 1: Stories of self: ‘Words to describe your mental health experience’ Discussion on an article brought by a participant about stigma and mental health. Exercise on sharing words that described their mental health experience. Discussions on response to their experience (shock); emotions (sadness, anger); and sense of support (being alone, stigma) | 4:1a | 30 (22-38) |
4 | Exercise 2: Stories of self: ‘Importance of sharing’ ‘Circle of friends’ exercise to identify individuals within their network they feel comfortable to sharing their experiences with. Discussions around self-stigma as a barrier to sharing, individual’s determination to seek help and the importance of talking as a way to make sense of experiences | 4:1b | 36 (35-37) |
5 | Introduction to stories/narratives Discussion on story genres and preferences, ownership of narratives on their mental health experiences and the creation of alternative narratives | 3:2 | 38 (36-40) |
6 | Exercise 3: Stories of coping: ‘getting here’ One participant shared the quote ‘we cannot repair the past but we can build the future’. Participants identified themes from their stories on the topic: hope, determination, willingness, openness, strength, courage, perseverance, control and choice | 3:2b | 36 (33-40) |
7 | Exercise 4: Stories of strengths and weaknesses: ‘daring to share’ One participant shared their story about facing fears of others’ view. Themes identified were courage and determination | 4:1 | 37 (34-40) |
8 | Exercise 5: Stories of strengths and weaknesses: on ‘daring to share’ (cont’d) Discussion on the importance of the personal meaning of their stories. The group generated discussions on the discrimination of mental health conditions in employment. Participants brainstormed ideas for the next topic ‘reconnecting’. This led to discussions around anger and coping strategies | 5:0 | 36 (32-40) |
9 | Exercise 6: Stories of strengths and weaknesses: ‘Reconnecting’ (As requested from the group, information was provided on local employment support groups.) Sharing and feedback on the topic. One member expressed being inspired by the storyteller. Members also shared their strategies in response to the storyteller’s struggle with anxiety. Discussions on reconnection beyond work and setbacks during recovery | 5:0 | 36 (29-40) |
10 | Ending and future (As requested by the group, information about volunteering, employment and local mental health support groups were shared.) Flipcharts were put on display to assist reflection of the past ten weeks. Reflections include: a change in attitude towards mental health, feeling ‘normal’, knowing that they are not alone, being able to identify with other people and an increase in confidence, courage and perseverance. The facilitator read a written letter addressed to each participant’s contribution to group. Participants shared tips, inspirations and goals for the future | 5:0 | 38 (34-40) |
Objective 5: Evaluation of Participant Response to Intervention
Participant | Recoveryc (QPR total) | Self-stigmad (BIS) | Insight totalc (ISMI-9) | Symptomsd (BSI) |
---|---|---|---|---|
1 | + 5 | − 0.07 | − 1.52 | − 15.92b |
2 | − 5 | − 0.44 | + 1.14 | − 7.08b |
3 | + 9b | − 0.22 | + 2.28 | − 6.6b |
4 | + 22b | + 0.06 | + 3.43b | − 45b |
5a | + 3 | − 0.78b | + 2.28 | − 43b |