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Targeting recovery in persistent persecutory delusions: A proof of principle study of a new translational psychological treatment (the Feeling Safe Programme).

Abstract:

Background

Many patients do not respond adequately to current pharmacological or psychological treatments for psychosis. Persistent persecutory delusions are common in clinical services, and cause considerable patient distress and impairment. Our aim has been to build a new translational personalized treatment, with the potential for wide use, that leads to high rates of recovery in persistent persecutory delusions. We have been developing, and evaluating individually, brief modular interventions, each targeting a key causal factor identified from our cognitive model. These modules are now combined in “The Feeling Safe Programme”.

Aims

To test the feasibility of a new translational modular treatment for persistent persecutory delusions and provide initial efficacy data.

Method

12 patients with persistent persecutory delusions in the context of non-affective psychosis were offered the 6-month Feeling Safe Programme. After assessment, patients chose from a personalized menu of treatment options. Four weekly baseline assessments were carried out, followed by monthly assessments. Recovery in the delusion was defined as conviction falling below 50% (greater doubt than certainty).

Results

11 patients completed the intervention. One patient withdrew before the first monthly assessment due to physical health problems. An average of 20 sessions (SD = 4.4) were received. Posttreatment, 7 out of 11 (64%) patients had recovery in their persistent delusions. Satisfaction ratings were high.

Conclusions

The Feeling Safe Programme is feasible to use and was associated with large clinical benefits. To our knowledge this is the first treatment report focused on delusion recovery. The treatment will be tested in a randomized controlled trial.

Publication status:
Published
Peer review status:
Peer reviewed

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Publisher copy:
10.1017/s1352465816000060

Authors


More by this author
Institution:
University of Oxford
Division:
Medical Sciences Division
Department:
Psychiatry
Role:
Author
More by this author
Institution:
University of Oxford
Division:
MSD
Department:
Psychiatry
Role:
Author
More by this author
Institution:
University of Oxford
Division:
Medical Sciences Division
Department:
Psychiatry
Role:
Author


Publisher:
Cambridge University Press
Journal:
Behavioural and Cognitive Psychotherapy More from this journal
Volume:
44
Issue:
5
Pages:
539-552
Publication date:
2016-04-01
DOI:
EISSN:
1469-1833
ISSN:
1352-4658
Pmid:
27044885


Language:
English
Keywords:
Pubs id:
pubs:614009
UUID:
uuid:a74e8edc-df14-433c-a80a-c4c703d761a9
Local pid:
pubs:614009
Source identifiers:
614009
Deposit date:
2017-10-17

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