Innovtions in psychosocial interventions for psychosis working with the hard to reach

Free ebooks ==> www.Ebook777.com www.Ebook777.com Free ebooks ==> www.Ebook777.com Innovations in Psychosocial Interventions for Psychosis Despite the steady acceptance of psychological interventions for people with psychosis in routine practice, many patients continue to experience problems in their recovery The need to develop new approaches, particularly for those who are more difficult to engage and have significant co-morbidities is therefore important Innovations in Psychosocial Interventions for Psychosis positions psychological formulation as a key organising principle for the delivery of care within multidisciplinary teams The interventions described all have the common theme of supporting recovery and achieving goals that are of primary importance to the service user which targets interventions on broader obstacles to recovery Along with their experienced contributors, Alan Meaden and Andrew Fox introduce new developments in psychological interventions for people affected by psychosis who are hard to reach, working in a variety of settings with people at various stages of recovery The book is divided into three parts In Part I brief interventions and approaches aimed at promoting engagement are described as interventions in their own right Part II is focussed on longer term interventions with individuals Some of these highlight new developments in the evidence base whilst others draw on work applied less frequently to psychosis drawing from the broader psychological therapy practice-based evidence field In Part III attention is given to innovations in group settings and those aimed at promoting greater multidisciplinary working in settings where a whole team approach is needed Each chapter describes the theory underpinning a different approach, its development, key strategies, principles and stages, and contains case examples that illustrate the use of the approach in a clinical setting Innovations in Psychosocial Interventions for Psychosis will be an invaluable resource for professionals working with this client group, including clinical and counselling psychologists, psychiatrists and other allied health professionals Alan Meaden is a consultant clinical psychologist at the Birmingham and Solihull Mental Health NHS Foundation Trust and is the lead for the trust’s Assertive Outreach and Non-Acute Inpatient Services Andrew Fox is a senior clinical psychologist at Birmingham and Solihull Mental Health NHS Foundation Trust www.Ebook777.com This page intentionally left blank Innovations in Psychosocial Interventions for Psychosis Working with the hard to reach Edited by Alan Meaden and Andrew Fox Free ebooks ==> www.Ebook777.com First published 2015 by Routledge 27 Church Road, Hove, East Sussex, BN3 2FA and by Routledge 711 Third Avenue, New York, NY 10017 Routledge is an imprint of the Taylor & Francis Group, an informa business © 2015 Alan Meaden and Andrew Fox The right of the editors to be identified as the author of the editorial material, and of the authors for their individual chapters, has been asserted in accordance with sections 77 and 78 of the Copyright, Designs and Patents Act 1988 All rights reserved No part of this book may be reprinted or reproduced or utilised in any form or by any electronic, mechanical, or other means, now known or hereafter invented, including photocopying and recording, or in any information storage or retrieval system, without permission in writing from the publishers Trademark notice: Product or corporate names may be trademarks or registered trademarks, and are used only for identification and explanation without intent to infringe British Library Cataloguing in Publication Data A catalogue record for this book is available from the British Library Library of Congress Cataloging in Publication Data Innovations in psychosocial interventions for psychosis : working with the hard to reach / Alan Meaden and Andrew Fox (Eds).—First Edition pages cm Includes index Psychoses—Patients—Services for Psychoses—Patients—Rehabilitation Psychoses—Alternative treatment I Meaden, Alan, 1961– editor II Fox, Andrew (Clinical psychologist) editor, RC512.I44 2015 362.2'6—dc23 2014035572 ISBN: 978-0-415-71070-1 (hbk) ISBN: 978-0-415-71073-2 (pbk) ISBN: 978-1-315-72845-2 (ebk) Typeset in Times New Roman by Keystroke, Station Road, Codsall, Wolverhampton www.Ebook777.com I would like to dedicate this book to my wife Ann whose support is always there and to Mark Swain for reminding me that there are no problems, only solutions waiting to be found Alan Meaden I would like to dedicate this to Amy, for her patience, and to Glynn Farmer for showing me that the owls are never what they seem Andrew Fox This page intentionally left blank Contents List of figures List of tables List of abbreviations List of contributors The need for innovation when providing services for the difficult to engage xi xiii xv xvii AlAN MEADEN AND ANDrEw Fox Part Innovations in engagement and brief therapies The Adapted open Dialogue appoach GErT vAN rENSBurG Using Pre-Therapy in forensic settings 22 rIcHArD BArkEr Adapting relapse Prevention strategies for use with difficult to engage populations 38 MorNA GIllESPIE Brief interventions and single sessions as stages in a change process for people with psychosis DEBorAH AllEN 55 viii Contents Part II Innovations in interventions for individuals 71 cognitive Behavioural Therapy for emotional dysfunction following psychosis: The role of emotional (dys)regulation 73 MArk BErNArD, cHrIS JAckSoN AND MAx BIrcHwooD compassion Focused Therapy for people experiencing psychosis 91 SoPHIE l MAyHEw An existential approach to therapy: Core values and therapeutic principles 111 cATHErINE AMPHlETT Enhancing social participation and recovery through a cognitive-developmental approach 129 ANDrEw Fox AND cHrIS HArroP 10 Telling stories and re-authoring lives: A narrative approach to individuals with psychosis 147 HElEN HEwSoN Part III Innovations in group and whole team interventions 165 11 Group rational Emotive Behaviour Therapy for paranoia 167 rIcHArD BENNETT AND louISE PEArSoN 12 Team-Based Cognitive Therapy for distress and problematic behaviour associated with positive symptoms 184 AlAN MEADEN, ANDrEw Fox AND DAvID HAckEr 13 Long-Term Supportive Psychotherapy as a team-based therapy 200 AlAN MEADEN AND HElEN HEwSoN 14 Team-Based Cognitive Therapy for problematic behaviour associated with negative symptoms ANDrEw Fox AND AlAN MEADEN 219 Free ebooks ==> www.Ebook777.com Contents 15 concluding remarks ix 234 ANDrEw Fox AND AlAN MEADEN Index 237 www.Ebook777.com Chapter 15 Concluding remarks Andrew Fox and Alan Meaden when psychological approaches began to gain increasing respectability (positioned as they still are as adjuncts to psychiatric interventions) in the early 1990s (e.g chadwick & lowe, 1990), they did so by largely targeting populations who were not responding to standard psychiatric treatment (e.g medication, rehabilitation) These innovations (cBT, Behavioural Family therapy, coping strategy enhancement, etc.) promised a breakthrough in treatment and were extensively trialled clients themselves often preferred these interventions to the side effects of medical treatments However, over two decades later there clearly remains a substantial group for whom these approaches have not proven to be of benefit (Jones et al., 2012; Meaden & Hacker, 2010) and there remains a need to continue to understand how current practice can be improved what emerges from the collection of approaches in this book is that not only is there an increasing range of therapies that can be offered (many with quite different value systems) but that they share many common features Many strongly advocate the use of formulation – not only at an individual level but also at a team level This notion of shared formulation encompasses not only the value of ensuring that all of those providing help so in a consistent manner but also ensures interventions not contradict each other crucially, shared formulations may also be harnessed to address unhelpful team dynamics which can often create barriers to effective care (e.g chapters 12 and 14) These principles may usefully be incorporated into existing approaches A second key lesson is that approaches which offer a different value base, are more person-centred, and pay attention to the person’s own strengths and context, tend to support engagement in therapy what is also apparent is that the goals of therapy may be usefully reconsidered In their seminal paper, Birchwood and Trower (2006) argued for the refocussing of goals around distress and behaviour The approaches collected here echo this sentiment, reinforcing the need for a refocussing of goals onto what troubles the person and is important to them and not on what diagnosis or symptoms the person may or may not have Sometimes the goals may be quite short-term (e.g identifying a solution, Chapter 5) or they may need to be quite long-term (Chapter 13) Therapeutic efforts may focus on less usual goals (e.g gaining a romantic partner, chapter 9) or different types of belief than those usually targeted in Concluding remarks 235 current cBT approaches (chapters 11 and 14) It seems apparent that an explicit consideration and agreement regarding a collaborative goal for intervention is critical when providing services to those who are difficult to engage Although some of the approaches described here are already the focus of research effort, the focus on less traditional goals may make them more difficult to measure in terms of routine outcomes (e.g symptom reduction) and less amenable to trial-based evaluation We believe that these outcomes are the most meaningful for the people who (albeit reluctantly) use our services, and it is these goals that increase the chances of positive outcome for service users In some cases, the interventions’ effects may also be difficult to separate from the efforts of others in the team and their input is invaluable in an era of scarce resources research that supports the evaluation of these outcomes in routine practice is more likely to fit with such approaches (i.e practice-based evidence) How to choose which therapy to offer remains an elusive question It will in part depend upon the therapist’s own values and position, the values of the team and the degree to which the team feel stuck and accepting of available alternatives of course, the client remains key, and some discussion, where possible, may usefully be had regarding what the approaches available might involve and which are most acceptable to the person Some of these approaches may be more readily apparent for certain individuals and difficulties or may be more easily delivered in particular settings (e.g for people receiving residential care) It is also apparent that consideration should be given to the systems and contexts involved in providing care for people with complex mental health needs and limited engagement often, it can be helpful to understand and formulate the local team or system Similarly, there is usually a need to engage people within the wider community, and this will depend very much on the communities that people have access to or wish to be part of rather than focussing on change within the individual, change needs to happen both from within and around the person, and this should be guided by the formulation The person (or people) delivering interventions must then be ready and able to target these interventions at the area suggested by the formulation and supported by services in this endeavour, regardless of whether these are considered as traditional treatment targets or not This may represent a challenge for services where psychosocial interventions are viewed as happening within a rigid set of rules and boundaries, but in order to maximise service user recovery, it is imperative that such presuppositions about the nature and form of intervention not detract from clinicians’ ability to offer and research these references Birchwood, M & Trower, P (2006) The future of cognitive–behavioural therapy for psychosis: not a quasi-neuroleptic The British Journal of Psychiatry, 188(2), 107–108 236 Andrew Fox & Alan Meaden Chadwick, P D & Lowe, C F (1990) Measurement and modification of delusional beliefs Journal of Consulting and Clinical Psychology, 58(2), 225–232 Jones, c., Hacker, D., cormac, I., Meaden, A & Irving, c B (2012) cognitive behaviour therapy versus other psychosocial treatments for schizophrenia Cochrane Database of Systematic Reviews, Issue Art No.: CD008712 doi: 10.1002/14651858.CD008712 pub2 Meaden, A & Hacker, D (2010) Problematic and risk behaviours in psychosis: A shared formulation approach Hove, E Sussex: Brunner-Routledge Index Aaltonen, J 6, 8, 13, 149 ABC mismatch 185 ABC model 85, 167, 168, 174, 177, 187, 190; application of, to psychosis 173 abstractions in psychotic dialogue 149 acceptance-based strategies 39 active listening 58, 101 Adam (case illustration) 157–60 Adams, M 112 Adapted open Dialogue (AoD) 14, 16, 19 adolescence: normative 130; transitory experiences of 129 adolescent development 129; socialcognitive aspects of 130 adolescent egocentrism 130 Adolescent Invulnerability Scale 132 Advance Directive(s) 44, 45, 48 affect, blunted 219 affect regulation 96, 97, 149 affective contact 27 affective dysregulation 74, 75, 80, 81 affective psychosis 74 Affective Style Questionnaire (ASQ) 79; poor 149 Alanen, Y O 5, 6, 8, 9, 203 Aldao, A 76, 77 alexithymia 94, 101 Alienated Self 133 Allen, D 55–67 Allison, G 134 Alred, D 173 Amanda (case illustration) 227–31 American Psychiatric Association, Diagnostic and Statistical Manual: DSM-IV 203, 204; DSM-V 203 Amphlett, c 111–27 Andersen, T 5, 9, 16 Anderson, H 9, 19 Andreasen, N c 219 Andrews, k 134 anhedonia 219, 223 Antecedent and coping Interview 190 antipsychotics 211 AoD: see Adapted open Dialogue AoT: see Assertive outreach Team appetitive pleasure vs consummatory pleasure 223 Arnkil, T E 10 Arnold-Baker, C 120, 125 Aslan (The Lion, The Witch and The Wardrobe) 105 Asperger’s Syndrome 134 ASQ: see Affective Style Questionnaire Assertive Outreach Team (AOT) 48, 50, 123, 124, 140, 211, 212 assertiveness training 138 Assessment of Social Skills 132 attachment difficulties 94, 130 attachment relationships, impact of childhood trauma on 55 attachment theory 92 attention seeking behaviour 226 Attitude to relapse Scale 39 audio diary 104 auditory hallucinations 17, 18, 49, 63, 82 autobiographical memory processing 149 avolition 219, 220, 222 Awareness of Early Signs Questionnaire 39 Awareness of Social Inference Test 132, 143 awfulising, as irrational belief 169 Badcock, J c 76, 77 Bakhtin, M 9, 10, 16 Bargenquast, r 147 238 Index Barker, P 22, 57, 61, 67 Barker, r 22–35 Barlow, D H 76, 77, 84, 86 barren narratives 148, 150, 152 Barrowclough, c 47 Basic Emotions Scale (BES) 78, 83 Bateman, A 101 BAVQ-R: see Beliefs About voices Questionnaire–revised Beall, S K 148 Bebbington, P E 92 Bechdolf, A 47 Beck, A T 74, 76, 81, 167, 174, 220, 222, 224 Bedi, N 201, 206 behavioural deficit(s) 135, 222–32 Behavioural Family Therapy 1, 234 belief(s): evaluative 169, 171 [and inferences, distinction between 168]; in-situation 185, 192, 223–6; irrational 168, 173, 179 [types of 169]; pan-situational 185, 187, 189–91, 224, 225, 228, 231; paranoid 159, 169, 174, 181, 215; psychotic 24, 185, 190; rational 168, 171, 173 Beliefs About voices Questionnaire– Revised (BAVQ-R) 80, 190 Beliefs and convictions Scale 190 Bellack, A S 130, 132, 133, 136, 141 Bennett, R 167–81 Bentall, r 115, 169 bereavement 124 Berking, M 77, 86 Bernard, M 73–86 Bertrando, P 11 BES: see Basic Emotions Scale Bichescu, D 148 Bijstra, J o 131 biological model of distress 123 biopsychosocial stress-vulnerability model 209 bipolar disorder 48; use of Relapse Prevention with 41 Birchwood, M 1, 38–40, 42, 44, 46, 48, 73–86, 93, 173, 184, 190, 193, 195, 234 Birmingham and Solihull Mental Health NHS Foundation Trust’s Assertive Outreach and Non-Acute Inpatient services 44 Blos, P 130 blunted affect 219 Boduszek, D 169 Body Reflections (BR) 30, 33 Bora, E 221 borderline personality disorder 76 Boscolo, l 11 Boston Psychotherapy study 207 Bourke, M E 208 Boyle, M 55 Br: see Body Reflections Braehler, C 91, 93, 108 Brand, r M 140 Brekke, J S 138 Brett-Jones, J 190 brief interventions: benefits of, for people with psychosis 55–69; theoretical background and development 55–8 British School of Existential Analysis 112 Brune, M 149 Bruner, J 148 Buber, M 22, 112 Buchanan, J 134 Buckley, l 200 Buddhism 92 Buhrmester, D 138 Burr, v 147 cacophonous narratives 150, 152 caffeine 42 campbell, M l 92 cannabis 49, 75, 121, 122, 178, 191 card sort(s) 44, 45, 46, 49 card sort exercise and timeline 39 care planning meetings 47 care Programme Approach reviews 50 carey, M 153 carlsmith, J 57 cArM: see cognitive Approach to risk Management carver, c S 132 case illustrations: Adam 157–60; Amanda 227–31; David 48–52; Dwayne 13–19; Harold 140–4; James 82–8; John (1) 31–4; John (2) 177–81; Josh 224–7; Liam 211–6; Maggie 101–8; Matthew 193–7; Paul 61–7; Sarah 123–6 catatonia, use of Pre-Therapy with 22 CBC-P: see challenging Behaviour checklist for Psychosis cBT: see cognitive Behavioural Therapy cBTp: see cognitive Behavioural Therapy for psychosis cErQ: see cognitive Emotional regulation Questionnaire Index cFT: see compassion Focused Therapy Chadwick, P D 73, 80, 99, 101, 106, 123, 126, 131–3, 135, 153, 161, 173, 176, 184, 190, 196, 234 chair work 98, 104 challenging Behaviour checklist for Psychosis (CBC-P) 225 childhood trauma 75, 77, 78; impact of, on attachment relationships 55 circular questioning 192 clarke, c 22 Clarke, J C 78 clinicians, role of 10 cMT: see compassionate Mind Training cognitive Approach to risk Management (cArM) 190–6, 222, 224, 229, 231, 232 cognitive Assessment of voices 190 cognitive Assonance 57 cognitive Behavioural model(s) 47, 161, 200, 221 cognitive Behavioural techniques/ interventions 147, 202, 207, 221 cognitive Behavioural Therapy (cBT) 1, 92, 150, 153, 173, 187, 193, 198, 201, 219–22, 224, 232–5; barriers to implementing 40; conceptual foundations of 167; developmental origins of 74; effectiveness with delusional beliefs 73; for emotional dysfunction following psychosis 73–86; group 47; narrative 150; for paranoia 169–71; for psychosis 169, 184–5; for schizophrenia 47 Cognitive Behavioural Therapy (CBT)based exposure intervention 86 cognitive Behavioural Therapy for psychosis (CBTp) 73, 74, 86 cognitive bias 229 cognitive deficits 139, 201, 220, 221, 223 cognitive development 138 cognitive-developmental approach, enhancing social participation and recovery through 129–44 cognitive Dissonance 57, 224, 226 cognitive Emotional regulation Questionnaire (CERQ) 79, 83 cognitive remediation 221, 232 cognitive restructuring 148, 169 cognitive techniques 137, 173, 191, 210 239 cognitive Therapy (cT) 131, 167, 174, 183, 184, 219; see also Cognitive Behavioural Therapy (cBT) coles, S 56 collins, w A w 131 command hallucinations 73, 193 communicative contact(s) 25, 27, 29 community mental health team 40, 211, 228 community Psychiatric Nurse (cPN) 211, 212, 214 compassion 23, 24, 91–5, 98–102, 104, 105, 108, 206, 216, 225; environment for the expression of 60 ‘compassion chair’ 98 compassion circle 99 Compassion Focused Therapy (CFT) 189; evolution of 91–4; for people experiencing psychosis 91–108; psychoeducation in 95–7 compassionate colour exercise 100, 105 compassionate Mind Training (cMT) 91, 93, 98, 99; experiential exercises 104–6 compulsory treatment 56 confabulations 149 confidentiality 101 connectedness, human, developing through Pre-Therapy 24 connor, c 93 constructionism 147 consummatory pleasure vs appetitive pleasure 223 contact: building 26, 34; psychological 22–4, 26, 28, 31 contact behaviour 26 contact reflections 26, 28, 34, 35; types of 29–32 containment 207, 214, 215 continuity of treatment 12 cooper, M 112, 113, 115, 117, 126 copeland, M E 39 coping/adaptive strategy(ies) 38–41, 44, 46–8, 50, 51, 59, 92, 94, 106, 190, 201, 207, 209, 210, 215; emotional 39 coping Strategy Enhancement (cSE) 39, 40, 48, 234 corrigan, P 57 cossof, J 75 countertransference 208 couture, S M 130, 134 cPN: see community Psychiatric Nurse crown, S 201 Free ebooks ==> www.Ebook777.com 240 Index cSE: see coping Strategy Enhancement (cSE) cT: see cognitive Therapy Dagnan, D 132, 133 Danish Schizophrenia Project (DNS) 201 Davenport, S 202, 205, 210 David (case illustration) 48–52 Dawson, M E 209 deconstructive questions 154 Deegan, P E 139 defence mechanisms 201, 207, 209 Dekeyser, M 25 delusional beliefs 73, 80, 150, 190 delusions 10, 23, 73, 204, 219, 220; paranoid 75, 93; persecutory 93 demandingness, as irrational belief 169 dementia, use of Pre-Therapy with 22 denial of experience 114, 121 depreciation, as irrational belief 169 Depression, Anxiety & Stress Scale 48 DErS: see Difficulties in Emotional regulation developmental abnormalities 75 developmental disabilities, use of Pre-Therapy with 23 developmental trauma 75 Dewald, P A 200 dialogical theory 202; of narrative coherence 149–50 dialogism 13 didactic disputation 137 difficult to engage populations, use of relapse Prevention strategies with 38–52 Difficulties in Emotional Regulation (DErS) 79 DiGiuseppe, r A 173 Dillon, J 55, 121, 123 DiLorenzo, T A 169 Dimaggio, G 149 discomfort tolerance 227 disinhibition 48 disputation 137, 176, 179, 180, 185, 186, 189, 191, 192 disputation process 173, 176, 179 dissociative experience 149 distress: biological model of 123; cognitive theories of 76 distress tolerance 65, 84, 98; problem solving 81; skills 81 DNS: see Danish Schizophrenia Project Docherty, J P 39 Dodds, l 22, 35 Douglas, k S 174 Drayton, M 42 Drennan, G 173 Drug Induced Psychosis 62 drug use 46, 62, 63, 122 Dryden, W 168, 169, 172, 173, 227 Dudley, r 57, 59, 204 Duggan, S 174 Dwayne (case illustrations) 13–19 Dysfunctional Separation-Individuation Scale 132 dysphoric symptoms 38 Early Intervention Service 82, 138 Early Signs Scale 39, 42, 46, 48 Early Warning Signs of Risk (EWS-R) 191, 192, 209, 222 EBS: see Evaluative Beliefs Scale eco-map 134 egocentricity, adolescent 130, 134 Eicher, A c 93 Eidelson, r J 132 Elis, o 219, 220 Elkind, D 130 Ellard, k k 169 Ellis, A 167–9, 174 emotion recognition, problems with 149 emotional awareness 209 emotional coping strategies 39 emotional distress and psychotic symptoms, association between 81 emotional dysfunction, post-psychotic: cognitive Behavioural Therapy for 73–86; pathways to 75 emotional regulation/dysregulation 75–81; deficits in 77, 86; maladaptive 84; role of 73–86 Emotional regulation Questionnaire (ERQ) 78, 79, 83 emotional regulation strategies, maladaptive 84 empathy 24, 60, 65, 98, 100, 113, 157, 206–8, 215, 216 entrapment 80, 83, 85, 86 Epstein, N 132, 139 Epston, D 151, 156 ErQ: see Emotional regulation Questionnaire Escher, A D 91, 92 www.Ebook777.com Index evaluative beliefs 169, 171; and inferences, distinction between 168 Evaluative Beliefs Scale (EBS) 132, 176 evidence-based strategies 222 evolutionary psychology 92 EWS-R: see Early warning Signs of risk existential anxiety 114, 115, 120, 122, 126 existential approach: as basis for therapeutic integration 116; to therapy 111, 123, 126 existential philosophy 115 existential therapy(ies) 112, 115, 116, 122, 126 Existentialism 112 expectancy 220, 222, 227, 229; of acceptance 224 [low 224]; of pleasure 224, 225 [low 224, 225]; of success 224 [low 224] exposure intervention, cognitive Behavioural Therapy (CBT)-based 86 expressive functioning 25, 27, 31 expressive suppression 76 facial reflections (FR) 29, 30, 33, 34 Falloon, I 39, 40 ‘false self’ 113 family therapy 1, Fears of compassion Scale 95 Fennell, M 86 Fenton, w S 201, 207 Festinger, l 57 Fett, A J 139, 221 fidelity to experience 114, 117 Finlay, l 126 first-episode psychosis 40 five area model 85 5Ps 57, 59–63, 204: approach 61; formulation 63 [model 57, 60; shared 59, 62]; Perpetuating factors 60, 204, 215; Precipitating factors 60, 204, 215, 216; Predisposing factors 60, 204, 215; Presenting difficulty 60, 61, 204; Protective factors 60, 63, 204, 215 Flanagan, S 132 flexibility and mobility of treatment 12 Fonagy, P 101 forensic settings use of Pre-Therapy in 22–35 Foster, J H 40, 47 Foussias, G 219, 220 Fox, A P 1–2, 129–44, 184–98, 219–32, 234–6 241 Fox, H 156 Fr: see facial reflections Frankenberger, k D 129 Freeman, D 93, 169, 190 Fresco, D M 76, 77, 84, 86 Freud, S 205 frustration tolerance, low, as irrational belief 169 Fulop, I E 169 Furman, W 138 Gabbard, G o 205 GAF: see Global Assessment of Functioning Scale Galán Rodriguez, A 39 Gallagher, S 149 Gard, D E 223 Garety, P A 93 Garland, A 85 genogram 134 George, S 46 Gergen, k J 147 Gestalt theoretical perspective 26 Gestalt therapy 23 Gilbert, P 56–60, 91–3, 95, 96, 98, 99, 102, 106, 132 Gillespie, M 38–52 Gleeson, J F M 38, 40 Global Assessment of Functioning Scale (GAF) 201 Gogtay, N 131 Graham, H l 49 Granefski, N 79 Grant, P M 135, 220 Gratz, K L 79 Green, l w Gregory, k 56, 59, 60, 63 Grenyer, B F 208 grey-zone functioning 25, 26, 28, 30, 34 Griffiths, R 40 Gross, J J 75–9, 86 group rational Emotive Behaviour Therapy, for paranoia 167–81 group relapse Prevention interventions 47 guided discovery 60, 100, 137; principle of 57 Gulf war 64 Gumley, A 55, 56, 74, 77, 84, 91, 93, 94, 106 Gunderson, J G 207 242 Index Hacker, D 1, 6, 135, 138, 184–98, 202, 204, 205, 209, 219, 221, 222, 225, 227, 234 Haddock, G 80, 190 Hafner, H 75 Hafner, r 75 Hagan, T 56–60, 63, 65 Hall, M 41 hallucination(s) 8, 10, 17, 18, 23, 31, 49, 63, 82, 93, 102, 104, 105, 204; command 73, 193; tactile 101; visual 101 Harold (case illustration) 140–4 Harper, D 156 Harris, N 40 Harrop, c 129–44 Harter, S 129 Hartley, S 74, 77, 81, 86 Harvey, A M 130, 169 Hearing voices Network 121 Heidegger, M 112 Henry, J D 76 Hepatitis c 62 heroin use 61–3, 65, 66, 101 Herz, M 38, 201 Hewitt, l 40 Hewson, H 147–61, 200–16 hierarchy of needs 207 Hirschfeld, R 138 HIv 61, 62 Hofman, S G 79 Hogarty, G E 201 Holma, J 8, 13, 149 Holmes, J 202, 210 Holmes, T H 44 Holmes and rahe Stress Scale 44 hopelessness 47, 124, 220, 225 Hulme, P 117, 123 Husserl, E 112 Hutton, P 93 Hyland, P 169 idealisation 210 IES-R: see Impact of Event Scale– revised illness conception/awareness 17, 156 ‘imaginary audience’ 130 Impact of Event Scale–Revised (IES-R) 78 incoherent descriptions in psychotic dialogue 149 inference(s) 26, 185, 207, 225; and evaluative beliefs, distinction between 168; paranoid 171, 172, 176, 177; role of in REBT 168 Insecure Self 133 Insight Scale 42, 43 in-situation beliefs 185, 192, 223–6 in-situation delusional interpretations of events 192 Insufficient Self 133 integrative psychotherapy, for psychosis 150 internal negative reinforcement 191 internal positive reinforcement 191 Interpretative Phenomenological Analysis (IPA) 126 IPA: see Interpretative Phenomenological Analysis Irons, C 91–3, 98, 106 irrational belief(s) 168, 173, 179; types of 169 Jablensky, A 137 Jackson, C 73–86 Jackson, M 208 Jacobsen, B 115, 117, 123 Jakes, S 147, 150, 161 James (case illustration) 82–8 John (1) (case illustrations): 31–4 John (2) (case illustrations): 177–81 John, o P 76, 79 Johnson, D P 91, 93 Johnstone, l 55 Jones, C 74, 169, 184, 200, 201, 234 Jonikas, J A 40 Jorgenson, P 38 Josh (case illustration) 224–31 Jumnoodoo, r 40, 47 Jumping to Conclusions 185 kashdan, T B 79 Kay, S R 74, 80 kelly, G 56, 60 kendler, k S 74 kierkegaard, S 111, 112, 126 kingdon, D 73, 93 kiser, S 121 klein, M 209 klingberg, S 232 knight, M T D 223 krabbendam, l 74 Kramer, I 74, 77, 81 kring, A M 76 kroger, J 130 Index kroole, S 75–7 kubiak, M 22 Kurtz, M M 221 kuyken, w 57, 59, 204 laing, r D 31, 112–17, 121, 123 laithwaite, H 91, 93 lambert, M J 176 lamberti, J S 201 lapsley, D k 130 lardinois, M 75, 77 larkin, w 55, 56 ‘laziness’, concept of 227 learning disabilities, use of PreTherapy with 22 lee, D 99, 104 lee, S H 40 Leszcz, M 47, 78 liam (case illustration) 211–16 lincoln, T 91, 93 livingston, k 74, 76 Lobban, F 38, 40 Long-Term Supportive Psychotherapy (LTSP), as team-based therapy 200–16 Lovibond, P F 48 Lovibond, S H 48 low frustration tolerance, as irrational belief 169 low, S 169, 171, 223, 227 lowe, c F 73, 234 lTSP: see Long-Term Supportive Psychotherapy (lTSP) Lynch, D 73, 184 Lysaker, J T 27, 148–50 lysaker, P H 27, 93, 147–50, 156, 201, 202 Mace, c 31 Maggie (case illustration) 101–8 Mahler, M S 130 malevolent voices 93, 97 Markham, D 204 Marmar, C R 78 Martell, c r 106 Masland, S 56 Maslow, A H 207 Matthew (case illustration) 193–7 Mattick, R P 78 May, r 121, 123 Mayhew, S L 91–108 McAdams, D P 148 Mccabe, c 201 243 McDonald, S 132, 143 Mcleod, J 150 McT: see Metacognitive Training MDT: see multidisciplinary team Meaden, A 1–2, 6, 41, 56, 105, 135, 138, 184–98, 200–16, 219–32, 234–6 medium secure care, challenges of 173–4 Melville, C 38 memory processing, autobiographical 149 Mennin, D S 76, 77, 84, 86 Mental Health Act 62, 122, 123, 187 metacognition 149; in psychosis 27 metacognitive functioning 202, 206; deficient, in psychosis 150 metacognitive reflection 148, 149 Metacognitive Training (McT) 139 methadone 101 Milev, P 219 Miller, w 56, 57, 59, 60 Mills, A 93 Milton, M 112, 116, 121 mindfulness 31, 81, 84, 105, 126, 196 mindfulness techniques 99 mobility and flexibility of treatment 12 monitoring strategies 46 monological narratives 150, 152 mood disorders 74 Mood rating Scale 46 Moritz, S 139, 185 Morrison, A 55, 56, 92, 149 Motivational Interviewing 59, 64 Motivational Interviewing questions 59 Mueser, k T 132, 149 multi-axial shared formulation 209 multidisciplinary team (MDT) 14–17, 19, 86, 156, 191, 202, 203, 208, 209, 212, 226 Murphy, J 55 mutual influence questions 154 Myin-Germeys, I 74, 77, 81, 84, 86 narrative, schizophrenia as chronic disintegration of 149 narrative breakdown in psychosis, types of 150 Narrative cBT 150 narrative coherence, dialogical theories of 149–50 Narrative coherence rating Scale (NcrS) 156 Narrative Exposure Therapy (NET) 148 244 Index narrative ideas for, relevance of, for individuals with psychosis 147–51 narrative impoverishment, in schizophrenia 27 Narrative Psychology 148 Narrative Therapy 11; for psychosis 147–61 ‘narrative thought’, capacity for 148 narrative transformation 156 narratives: barren 148, 150, 152; cacophonous 150, 152; monological 150, 152 NAT: see Need Adapted Treatment National Institute for Health and care Excellence (NIcE) 1, 41, 73, 74, 219; Guidelines for Schizophrenia 73 NcrS: see Narrative coherence rating Scale Need Adapted Treatment (NAT) 5, 8, 14, 203; concept and principles of 6–7 Needle and Syringe Exchange (NSE) 61, 64, 66 negative reinforcement, internal 191 negative self-evaluation 92 negative symptoms 35, 75, 135, 149, 150, 173, 219, 222, 226, 231, 232; cognitive theory of 221; understanding 220 negative transference relationships 205 negativity 48 neologisms 30 NET: see Narrative Exposure Therapy Neuchterlein, K H 38 neuroleptic medication/treatment 6, 13 neuroleptics 7, 74 neurophysiology 92 neurosis(es) 74 NIcE: see National Institute for Health and care Excellence Nietzsche, F 112 Nolen-Hoeksema, S 76, 77 non-affective psychosis 74 NSE: see Needle and Syringe Exchange Nuechterlein, k H 209 oD: see open Dialogue old brain–new brain 96 ontological insecurity 113, 114, 115 ontological security 113, 114, 120, 122 open Dialogue (oD) 5–20, 150–2; development and implementation of 7–8 operant conditioning 57 OQ-45: see outcome Questionnaire Outcome Questionnaire (OQ-45) 176, 180 outsider witness practices 155, 156 Padesky, C 57, 58, 60 Palmer, B w 221 pan-situational belief(s) 185, 187, 189–91, 224, 225, 228, 231 PANSS: see Positive and Negative Symptom Scale paranoia 32, 39, 82, 83, 85, 86, 93, 124, 129, 219; group rational Emotive Behaviour Therapy for 167–81; use of Pre-Therapy with 24 paranoid beliefs/delusions 75, 93, 159, 169, 174, 181, 215 paranoid ideation 97, 130, 179 paranoid inferences 171, 172, 176, 177 paranoid schizophrenia 48, 174 parents, separation-individuation from 129 Pascal, B 55 Paul (case illustration) 61–7 PBcT: see Person-Based Cognitive Therapy PBIQ-R: see Personal Beliefs about Illness Questionnaire–revised Pearson, L 167–81 peer group socialisation 129 Penn, D l 139, 201 Pennebaker, J W 85, 148 Perkins, r Perls, F 23, 26 Perona Garcelán, S 39 Perpetuating factors, in 5Ps formulation model 60, 204, 215 Perry, y 77 persecutory delusions 93 Person-Based Cognitive Therapy (PBCT) 131 personal agency 156 Personal Beliefs about Illness Questionnaire–Revised (PBIQ-R) 80, 83 Personal construct Theory 56 ‘personal fable’ 130 Personal uniqueness Scale 132 personality development 56 personality disorder(s) 76, 202, 208 Peters, S 40 Pettit, T 200 Pfammatter, M 221 phenomenological approach 113, 118, 124 phenomenology 18, 112 Index Phillips, K F V 76, 78, 79 Polkinghorne, D 148 Pontin, E 40 Pörtner, M 22 Positive and Negative Symptom Scale (PANSS) 74, 80, 201 positive reinforcement, internal 191 positive transference 208, 210, 215 post-psychotic depression 77, 80, 83 post-psychotic emotional dysfunction 77, 80, 81, 84, 86 post-psychotic trauma 74, 80 post-traumatic stress disorder 74 Power, M 76, 78, 79 practice-based evidence 2, 126, 235 Prasko, J 147 Precipitating factors, in 5Ps formulation model 60, 204, 215, 216 Predisposing factors, in 5Ps formulation model 60, 204, 215 pre-expressive functioning 25, 26, 29, 31, 35 preferred story 155, 159, 160 premorbid personality traits 220 Presenting difficulty, in 5Ps formulation model 60, 61, 204 Pre-Therapy: application of, to psychosis 31–4; developing human connectedness through 24; practice of 28; theoretical background and development of 22–4; use of, in forensic settings 22–35 Pre-Therapy network 35 principle of ‘universality’ 47, 78 ‘problem’ definition 61 ‘problem’ questions 61 ‘problem’ representation (case example) 65; model of 58 problem solving 35, 81, 191, 207; use of 85 problem-solving strategies 39 Procter, S 91 projective identification 210 Protective factors, in 5Ps formulation model 60, 63, 204, 215 Prouty, G 22–7, 31 psychoeducation 43, 94, 95, 104, 159, 209, about psychosis 47 psychological contact 22–4, 26, 28, 31 psychometric assessments 152 psychosis(es) (passim): acute 21, 149; affective and non-affective 74; 245 application of ABc model to 173; application of Pre-Therapy to 31–4; cognitive Behavioural Therapy following 74; compassion-based approaches for 93; emotional dysfunction following [cognitive Behavioural Therapy for 73–86; pathways to 75]; first-episode 40; incipient 48; individuals with [benefits of single sessions and brief interventions for 55–67, compassion Focused Therapy for 91–108, relevance of narrative ideas for 147–51]; integrative psychotherapy for 150; meta-cognition in 27; metacognitive deficits in 150; narrative breakdown in, types of 150; narrative impoverishment in 149; narrative interventions for 147–61; poor or dysfunctional psychological reaction to 75; positive and negative symptoms of 75; psychoeducation about 47; role of trauma in 55; shame related to 93; use of Pre-Therapy with 22 psychosocial development, disruptions to 129 psychotherapy, supportive 200–2, 205, 206 psychotic beliefs 24, 185, 190 psychotic dialogue, incoherent descriptions, confabulations and abstractions in 149 psychotic experience(s): persistent 80; pre-narrative quality of psychotic relapse(s) 38, 39, 49, 77, 207, 215 psychotic speech 9, 16 psychotic symptom(s) 1, 7, 23, 39, 56, 74, 77, 80, 93, 94, 135, 147, 149, 184, 190; break-through 75, 81, 84; and emotional distress, association between 81 Psychotic Symptom rating Scales (PSYRATS) 80, 190 PSyrATS: see Psychotic Symptom rating Scales rahe, r H 44 räkköläinen, v randomised controlled Trials 74 rational beliefs 168, 171, 173 rational Emotive Behaviour Therapy (rEBT) 227; group, for paranoia 167–81 read, J 55, 75, 115 246 Index reality anchoring 25 reality contact 27 rEBT: see rational Emotive Behaviour Therapy recovery Style Questionnaire 42, 49 rector, N A 220, 222, 223, 232 Redmond, C 130, 134, 138 reflective process, as transition between listening and talking regulation of Emotions Questionnaire (REQ) 79, 83 reiterative reflections (RR) 30, 31, 33, 34 relapse, triggers to 39–41 relapse Prevention 1; assessing suitability for 42–3; engaging difficult to reach service users in 41–2; strategies, use of 38–52; ten-stage model of 39; theoretical background and development 38–41 relapse Prevention groups 47 relapse Prevention manual 44–6 Relapse Prevention Plan 38, 41, 50 relapse Prevention sessions 44 relapse Prevention/wellness action planning approach 47 relapse signature 38, 39, 41, 46 remington, G 219, 220 rEQ: see regulation of Emotions Questionnaire rhodes, J 147, 150, 161 richardson, c l 221 risk-awareness training 138 roberts, D l 139 roberts, G A 147, 149 Robinson, D G 88, 96, 219 roe, D 153 roemer, l 79 Rogers, C 23, 58 role plays 141 rollins, J 132 rollnick, S 56, 57, 59, 60 Romantic Beliefs Inventory 132, 138 romantic dyads, exploration of 129 romantic relationships 134, 135, 137, 213 romme, M A J 91, 92 rosenbaum, B 201 rr: see reiterative reflections russell, S 153 rutherford, M 174 SAFE: see Shared Assessment, Formulation and Education Safe group 178, 179 Safe Place 100, 105 Safe programme 167, 174–9, 181 Safety Behaviour Scale 190 Sainsbury centre for Mental Health 41 Sanders, P 24, 25, 28 Sarah (case illustration) 123–6 Sarbin, T 147 Sartre, J.-P 112 Scale To Assess Narrative Development (STAND) 156 Schauer, M 149 Scheier, M F 132 schizoaffective disorder 123, 211, 212, 215, 227 schizophrenia 1, 5, 13, 23, 55, 153, 155, 202, 205, 220; as chronic disintegration of narrative 149; cognitive Behavioural Therapy (CBT) for 47; diagnosis of 18, 173, 193, 223; narrative impoverishment in 27; negative symptoms of 219; paranoid 48, 174; supportive therapy with 201; use of relapse Prevention with 41 Schwannauer, M 74, 77, 84 Schweitzer, R 147 ScIT: see Social cognition and interaction training Seagal, J D 148 Seikkula, J 5, 7–13, 15, 16, 19, 152, 201 Self and other Scale 132, 133 self-consciousness 129, 132, 133, 137, 143 Self-Consciousness Scale 132 self-construction 116, 131, 133–7, 142–4 self-evaluation, negative 92 self-harming 94 self-identity, coherent, development of 129 self-medication strategy 39 self-soothing 91, 94, 98 Semerari, A 149 separation anxiety 178 separation-individuation 130; from parents 129 Service level Formulation 227 shame: related to psychosis 93; role of 59 Shared Assessment, Formulation and Education (SAFE) 135, 219, 221, 222, 232 shared formulation 59, 62, 156, 186, 203, 205, 215, 221, 228, 234; concept of 6; multi-axial 209; team-based, developing 225 Index shared mental representation, concept of short intervention: aim of 58, 136; stages of 59–60 single sessions, benefits of, for people with psychosis 55–69 situational reflections (SR) 29, 33, 34 6Ps 215 Slade, M 28 Sloan, D M 76 Smail, D 56–8, 65 Smith, J 39, 44 Smith, J A 126 Smith, l 170 social alienation 156 social anxiety 74, 75, 78, 82–4, 86, 101, 102, 132, 139 social avoidance 75, 140 social beliefs 133–7 social cognition 130, 133–6, 139 Social cognition and Interaction Training (ScIT) 139 social cognitive deficits 221 social cognitive training therapies 221 social constructionism 148, 160 social network(s) 6–8, 12–13, 15, 131, 133–6, 138, 139, 141, 180, 212; patient’s 10, 11 social participation and recovery, enhancing, cognitive-developmental approach to 129–44 social skills 130, 131, 133–6, 138, 141 social skills training 136 social withdrawal 9, 13, 93, 129, 150, 219, 220 Socratic questioning 35, 137 ‘soulfulness’ 116 speech, poverty of 219 Spellman, D 156 Spinelli, E 112, 117 Spinhoven, k P 79 splitting 113, 205, 210, 213 Sr: see situational reflections STAND: see Scale To Assess Narrative Development Stern, S 10 stress triggers 39 Subjective omnipotence Scale 132 Subotnik, K L 38 substance abuse 94 suicidal ideation 101, 124 Sullivan, H S 205 Sullivan, P r 200 247 Summers, A 205 supported discovery 101 supportive psychotherapy 200–2, 205, 206 supportive therapy, with schizophrenia 201 Sutela, M symbolism 23; higher-level 27; lowerlevel 27 Systemic Family Therapy 11 tactile hallucinations 101 Tai, S 77, 81, 86 Tait, L 78 Talbot 39, 40 talking therapy 56 Talmon, M 56, 66 Tarrier, N 1, 39, 40, 190, 207 TBcT: see Team-Based Cognitive Therapy team-based approaches 47, 192, 198, 200, 202, 208, 221, 225, 229 Team-Based Cognitive Therapy (TBCT): care plan 189; for distress and problematic behaviour associated with positive symptoms 184–98; for problematic behaviour associated with negative symptoms 219–32 team-based therapy, Long-Term Supportive Psychotherapy as 200–16 team debriefs 46–7 theory of mind (ToM) 132, 134, 139, 149, 221 therapeutic alliance 111, 172, 203, 205, 206; tolerating 214 therapeutic engagement 135, 161 ‘therapeutic hour’, strict boundaries of 121 therapeutic integration, existential approach as basis for 116 therapeutic relationship 94, 101, 106, 119, 126, 137, 140, 143, 170, 173, 178, 201, 202, 206; building of 23; longer term 55 therapy(ies), existential 111, 112, 115, 116, 122, 123, 126 ‘third wave’ cognitive Behavioural Therapy approaches 86 Thompson, M G 112, 114 thought disorder 30 Three circles Model 96, 97, 102 Tidal Model 61, 67 Tillich, P 112, 114 time-line exercise 159 ToM: see theory of mind trandiagnostic model of therapy 181 Free ebooks ==> www.Ebook777.com 248 Index transference 201, 204, 205, 214, 215; positive 208, 210, 215 transference patterns 205 transitional object 105 Tranulis 153 trauma: childhood 75, 77, 78 [impact of, on attachment relationships 55]; early, role of 115; and feelings of shame 56; post-psychotic 74, 80; role of, in psychosis 55, 56 treatment: continuity of 12; flexibility and mobility of 12 Treatment Meeting(s) 7–13, 19 triggers to relapse 39–41 Trower, P 73, 74, 81, 86, 123, 129–33, 137, 144, 173, 184, 204, 234 ‘true self’ 113 Turkington, D 77, 81, 86, 169 Turku Schizophrenia Project Turner, M 55–7, 75, 80, 91, 93 uncertainty, tolerance of 12 unique outcome questioning 159 unique outcomes 154–6, 158–60 ‘universality’, principle of 47, 78 urban living 75 van der Meer, l 77 van Deurzen, E 111–13, 115, 120, 125–7 van Deurzen-Smith, E 114, 120 Van Marle, S 202, 203, 208, 210 van Os, J 74, 75, 77, 81, 84, 86 van rensburg, G 5–20 van Rossum, I 74, 77, 81 van werde, D 24, 25, 31, 34 vartanian, l r 130 vassiliadis, H 201, 206 visions 116, 119, 120, 122 visual hallucinations 101 voice compliance 73 voices 73, 104, 106, 147, 154, 158–9, 173, 181, 190, 219, 220; break-through 86; cognitive therapy for 195; control over 64, 66, 101, 105; derogatory, critical, self-critical, persecutory, omnipotent 82, 94, 101, 178, 191; hearing/experiencing 17–19, 39, 42, 56, 61, 64–6, 80, 82, 83, 93, 116, 117, 120, 122, 124, 140, 157, 193, 194, 196; malevolent, persecutory, threatening 75, 93, 97, 120, 196; powerful 56; relationship with 194–6; shouting at 193–6; working with 153 wahl, o F 151 waldinger, r J 131 webster, c D 134 Weiss, D S 78 wellness recovery Action Plan (wrAP) 39, 40, 43 werman, D S 200 White, R 56, 147, 148, 150, 151, 153–6 whomsley, S 202 wilkinson, c E 15 williams, c H J 40 Williams, C J 85 winston, A 200 Woodward, T S 185 word-for-word reflections (WWR) 30, 33, 34 word salads 30 ‘worry monster’ 153 wrAP: see wellness recovery Action Plan wwr: see word-for-word reflections Wykes, T 74, 139, 184, 219, 221 Yalom, I D 47, 78 Yung, A R 1, 84, 200 www.Ebook777.com ... www.Ebook777.com Innovations in Psychosocial Interventions for Psychosis Despite the steady acceptance of psychological interventions for people with psychosis in routine practice, many patients continue to. .. Psychosocial Interventions for Psychosis positions psychological formulation as a key organising principle for the delivery of care within multidisciplinary teams The interventions described all have the. .. clinical setting Innovations in Psychosocial Interventions for Psychosis will be an invaluable resource for professionals working with this client group, including clinical and counselling psychologists,