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Sleep disruption and its psychological treatment in young people at risk of psychosis: A peer methods qualitative evaluation

Abstract:

Objectives A recent randomized controlled feasibility trial showed that sleep problems in young people at risk of psychosis can be successfully treated with psychological therapy and that this may bring additional benefits such as reducing depression, anxiety and paranoia. Here we report participants' qualitative experience of sleep problems and therapy.

Design A peer-methods qualitative study employing reflexive thematic analysis.

Methods Semi-structured interviews, co-facilitated by peer researchers, were conducted with 16 young patients at risk of psychosis and having sleep problems who participated in the SleepWell Trial (ISRCTN85601537). Ten interviewees had received the 12-week sleep therapy.

Results Four themes were generated: (1) the challenge to access mental health treatment (‘bouncing between services’), (2) sleep problems and mental health difficulties are intertwined (‘an obvious link’), (3) flexibility in therapy provision matters (‘tailored to me as a person’) and (4) improving sleep leads to wider benefits (‘fixing the sleep helped everything else’). Participants described a frustrating journey to access mental health treatment, marked by rejection and invalidation, which resulted in hopelessness and often resignation. The interaction between sleep disruption and other mental health difficulties was seen as obvious. Treatment for sleep problems was highly valued. The clear focus, therapeutic style and flexible delivery of the treatment was seen to create patient ownership, active engagement and hope. Participants described transformative changes: better sleep, fewer voices and fears and improved mood and confidence. Improving sleep made a difference to everyday life.

Conclusions Treating sleep problems in people at risk of psychosis is highly valued and often brings rapid and widespread improvements across a range of domains.

Publication status:
Published
Peer review status:
Peer reviewed

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Publisher copy:
10.1111/bjc.70002

Authors


More by this author
Institution:
University of Oxford
Division:
MSD
Department:
Experimental Psychology
Oxford college:
Reuben College
Role:
Author
ORCID:
0000-0002-2749-1386


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Funder identifier:
https://ror.org/04c8bjx39
More from this funder
Funder identifier:
https://ror.org/0187kwz08


Publisher:
Wiley
Journal:
British Journal of Clinical Psychology More from this journal
Publication date:
2025-07-06
Acceptance date:
2025-06-18
DOI:
EISSN:
2044-8260
ISSN:
0144-6657


Language:
English
Keywords:
Pubs id:
2134331
Local pid:
pubs:2134331
Deposit date:
2025-07-07

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