25 results on '"Lobban, Fiona"'
Search Results
2. A qualitative exploration of the contribution of blue space to well‐being in the lives of people with severe mental illness.
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Wright, Kim, Eden, Samantha, Hancox, Anna, Windget, Danielle, Elliott, Lewis, Glossop, Zoe, Johnston, Gordon, Johnston, Rose I., Lobban, Fiona, Lodge, Christopher, Palmier‐Claus, Jasper, Parkin, Sally, White, Piran C. L., and Bell, Sarah L.
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PEOPLE with mental illness ,INDIVIDUAL differences ,PLACE attachment (Psychology) ,WELL-being ,PSYCHIATRIC research ,MENTAL depression ,ANXIETY disorders - Abstract
The majority of research into the mental health benefits of blue space (outdoor places where water is a central feature) has focussed on the associations between neighbourhood exposure to these spaces and population‐level incidence of unipolar depression or anxiety disorder. There has been little exploration of the therapeutic use of blue space by those navigating bipolar, schizophrenia or other psychotic conditions. Knowledge arising from such an exploration could assist in the design and optimisation of nature‐based care for people with these conditions, as well as with self‐management.We conducted semi‐structured online and telephone interviews with 19 adults who self‐reported experience of these conditions. Interviews were conducted in the United Kingdom from August to December 2021.We describe four of the key interpretive themes identified via an in‐depth inductive thematic analysis of the interview transcripts to highlight how participants sought out moments of affective sanctuary through their blue encounters. Blue spaces were described as having the potential to reset the mind, emotions and body. This was in part due to their socially undemanding nature, and ability to provide respite from a socially stressful world.Participants described developing a blue identity, whereby a sense of attachment to and shared history with these places was articulated as well as incorporating blue spaces into self‐ and emotion‐regulation practices. Finally, participants described experiences of and recommendations for a therapeutic blue intervention. The role of biodiversity in contributing to the benefits of blue spaces was implied primarily in terms of perceived soundscapes, but also through visual observations.Synthesis and applications. Blue care for people with bipolar, schizophrenia or other psychotic conditions should consider the need that some individuals have for solitude and proximity to their home when they visit blue spaces, as well as individual differences in the features of blue space interactions that provide the greatest benefit. Read the free Plain Language Summary for this article on the Journal blog. Read the free Plain Language Summary for this article on the Journal blog. [ABSTRACT FROM AUTHOR]
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- 2024
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3. A psychological intervention for suicide applied to non-affective psychosis: the CARMS (Cognitive AppRoaches to coMbatting Suicidality) randomised controlled trial protocol
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Gooding, Patricia A., Pratt, Daniel, Awenat, Yvonne, Drake, Richard, Elliott, Rachel, Emsley, Richard, Huggett, Charlotte, Jones, Steven, Kapur, Navneet, Lobban, Fiona, Peters, Sarah, and Haddock, Gillian
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- 2020
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4. Demographic predictors of wellbeing in Carers of people with psychosis: secondary analysis of trial data
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Hazell, Cassie M., Hayward, Mark, Lobban, Fiona, Pandey, Aparajita, Pinfold, Vanessa, Smith, Helen E., and Jones, Christina J.
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- 2020
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5. Clinical effectiveness of a web-based peer-supported self-management intervention for relatives of people with psychosis or bipolar (REACT): online, observer-blind, randomised controlled superiority trial
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Lobban, Fiona, Akers, Nadia, Appelbe, Duncan, Chapman, Lesley, Collinge, Lizzi, Dodd, Susanna, Flowers, Sue, Hollingsworth, Bruce, Johnson, Sonia, Jones, Steven H., Mateus, Ceu, Mezes, Barbara, Murray, Elizabeth, Panagaki, Katerina, Rainford, Naomi, Robinson, Heather, Rosala-Hallas, Anna, Sellwood, William, Walker, Andrew, and Williamson, Paula
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- 2020
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6. A qualitative exploration of service user views about using digital health interventions for self-management in severe mental health problems
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Berry, Natalie, Lobban, Fiona, and Bucci, Sandra
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- 2019
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7. Acceptability of a novel suicide prevention psychological therapy for people who experience non‐affective psychosis.
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Harris, Kamelia, Gooding, Patricia A., Awenat, Yvonne, Haddock, Gillian, Cook, Leanne, Huggett, Charlotte, Jones, Steven, Lobban, Fiona, Peeney, Ellen, Pratt, Daniel, and Peters, Sarah
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SUICIDE ,CONFIDENCE ,SUICIDE prevention ,PSYCHOSES ,RESEARCH methodology ,INTERVIEWING ,PATIENTS' attitudes ,CONCEPTUAL structures ,QUALITATIVE research ,SUICIDAL ideation ,SUICIDAL behavior ,SELF-efficacy ,MEDICAL care use ,SOUND recordings ,DESCRIPTIVE statistics ,RESEARCH funding ,THEMATIC analysis ,DATA analysis software ,COGNITIVE therapy ,PSYCHOSOCIAL factors - Abstract
Objectives: Suicide is a leading cause of death worldwide. People experiencing psychosis are at increased risk of death by suicide. Talking therapies can alleviate suicidal thoughts, plans, and attempts. Therapies need to also be acceptable to recipients. The aim of this study was to investigate the views on psychological therapy for people experiencing psychosis and suicidality using the Theoretical Framework of Acceptability. Design: Qualitative interview study. Methods: Participants were recruited from a randomised controlled trial comparing suicide prevention psychological therapy with treatment as usual. Individuals had a diagnosis of non‐affective psychosis and experience of suicidal thoughts, plans and/or attempts. To assess the acceptability of the therapy, semi‐structured interviews were conducted with 20 participants randomised to receive therapy. Data were deductively analysed using an adaptation of the Theoretical Framework of Acceptability. Results: Interviews (Mean = 45 min) were conducted and audio recorded with 21 participants. Data were organised into six themes: 1. Affective attitude, 2. Burden, 3. Alliance, 4. Intervention coherence, 5. Perceived effectiveness, and 6. Self‐efficacy. There was no evidence of issues relating to domains of ethicality and opportunity costs associated with receiving therapy. Conclusions: Talking about suicide was difficult and, at times, distressing, but it was perceived to be useful for understanding experiences. To be acceptable, it is important for therapists to ensure that clients' understanding of therapy aligns with expectations of effectiveness and to invest in building strong therapeutic alliances. Future research will benefit from examining therapists' experiences of delivering therapy through different modes (e.g. online, telephone). [ABSTRACT FROM AUTHOR]
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- 2023
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8. What is important to service users and staff when implementing suicide-focused psychological therapies for people with psychosis into mental health services?
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Peters, Sarah, Awenat, Yvonne, Gooding, Patricia A., Harris, Kamelia, Cook, Leanne, Huggett, Charlotte, Jones, Steven, Lobban, Fiona, Pratt, Daniel, and Haddock, Gillian
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MENTAL health services ,PSYCHOTHERAPY ,MENTAL health personnel ,MEDICAL personnel ,SUICIDE risk factors ,SUICIDE statistics ,SUICIDAL behavior in youth ,COMMUNITY mental health services - Abstract
Introduction: Suicide is a leading cause of death globally. People with psychosis are at increased risk of suicide death and up to half experience suicidal thoughts and/or engage in suicidal behaviors in their lifetime. Talking therapies can be effective in alleviating suicidal experiences. However, research is yet to be translated into practice, demonstrating a gap in service provision. The barriers and facilitators in therapy implementation require a thorough investigation including the perspectives of different stakeholders such as service users and mental health professionals. This study aimed to investigate stakeholders' (health professionals and service users) perspectives of implementing a suicide-focused psychological therapy for people experiencing psychosis in mental health services. Methods: Face-to-face, semi-structured interviews with 20 healthcare professionals and 18 service users were conducted. Interviews were audio recorded and transcribed verbatim. Data were analyzed and managed using reflexive thematic analysis and NVivo software. Results: For suicide-focused therapy to be successfully implemented in services for people with psychosis, there are four key aspects that need to be considered: (i) Creating safe spaces to be understood; (ii) Gaining a voice; (iii) Accessing therapy at the right time; and (iv) Ensuring a straightforward pathway to accessing therapy. Discussion: Whilst all stakeholders viewed a suicide-focused therapy as valuable for people experiencing psychosis, they also recognize that enabling successful implementation of such interventions will require additional training, flexibility, and resources to existing services. [ABSTRACT FROM AUTHOR]
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- 2023
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9. An Interpersonal CBT Framework for Involving Relatives in Interventions for Psychosis: Evidence Base and Clinical Implications
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Lobban, Fiona and Barrowclough, Christine
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- 2016
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10. The impact of low secure unit care on patient outcomes
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Jones, Steven, Lobban, Fiona, Evershed, Kate, Taylor, Lee, and Wittkowski, Anja
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- 2008
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11. Use of an Online Forum for Relatives of People With Psychosis and Bipolar Disorder: Mixed Methods Study.
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Jones, Steven, Atanasova, Dimitrinka, Dodd, Susanna, Flowers, Susan, Rosala-Hallas, Anna, Robinson, Heather, Semino, Elena, and Lobban, Fiona
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EVALUATION of medical care ,STATISTICS ,SOCIAL support ,PSYCHOSES ,INTERNET ,RESEARCH methodology ,MEDICAL care ,FISHER exact test ,MENTAL health ,RANDOMIZED controlled trials ,SUPPORT groups ,RESEARCH funding ,QUESTIONNAIRES ,DESCRIPTIVE statistics ,SOCIODEMOGRAPHIC factors ,THEMATIC analysis ,STATISTICAL sampling ,DATA analysis software ,DATA analysis ,BIPOLAR disorder ,PSYCHOLOGICAL distress - Abstract
Background: Relatives of people with psychosis or bipolar disorder experience high levels of distress but are typically not offered the support they need. Online peer forums may offer a solution, but knowledge about who uses them, how, and why is limited. This study reported on online forum use during the Relatives Education and Coping Toolkit (REACT) trial. Objective: We aimed to report who used the forum and why; how sociodemographic factors are associated with participation; the relationship among frequency, type of use, and outcomes; and how the forum was used. Methods: The relationships between key sociodemographic characteristics, levels of forum use, and distress were statistically analyzed. We used thematic and semantic analyses to understand the reasons for relatives joining the forum and the key topics initiated by them. We also used the University Centre for Computer Corpus Research on Language Semantic Analysis System to compare how relatives and REACT supporters (moderators) used the forum. Results: A total of 348 participants with full forum use data from REACT were included in this study. The forum was accessed by 59.4% (207/348) of the relatives across the entire age range, with no significant associations between sociodemographic factors and forum participation, or between level or type of use and relatives' distress levels. Relatives joined the forum primarily to find people in similar circumstances, express concerns, and talk about stressful events. Relatives were most concerned about recent events, negative emotions linked to caring, experiences of conflict or threat, and concerns about suicide. These posts underscored both the challenges the relatives were facing and the fact that they felt safe sharing them in this context. Conclusions: Although only a proportion of REACT participants engaged actively with its forum, they were widely distributed across age and other sociodemographic groupings. Relatives used the forum for information, support, and guidance and to offer detailed information about their experiences. The topics raised highlighted the burden carried by relatives and the potential value of easy-access, moderated, peer-supported forums in helping relatives to manage the challenges they faced. [ABSTRACT FROM AUTHOR]
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- 2022
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12. Psychotic experiences in people who have been sexually assaulted
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Kilcommons, Aoiffe M., Morrison, Anthony P., Knight, Alice, and Lobban, Fiona
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- 2008
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13. Use of the Internet and Mobile Phones for Self-Management of Severe Mental Health Problems: Qualitative Study of Staff Views
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Berry, Natalie, Bucci, Sandra, and Lobban, Fiona
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bipolar disorder ,Original Paper ,mobile phone ,Internet ,Clinicians ,Bipolar disorder ,Intervention ,thematic analysis ,Psychosis ,digital health interventions (DHI) ,mental healthcare staff ,mHealth ,clinicians ,eHealth ,psychosis ,Mobile phone ,intervention - Abstract
Background: Researchers are currently investigating the feasibility, acceptability, and efficacy of digital health interventions for people who experience severe mental health problems such as psychosis and bipolar disorder. Although the acceptability of digital health interventions for severe mental health problems appears to be relatively high and some people report successfully using the Internet and mobile phones to manage their mental health, the attitudes of mental health care staff toward such approaches have yet to be considered.Objective: The aim of this study was to explore mental health care staff experiences of clients with severe mental health problems engaging with the Internet and mobile phones to self-manage their mental health and their views toward these behaviors. The study also sought to examine the opinions expressed by mental health care staff toward digital health interventions for severe mental health problems to identify potential facilitators and barriers to implementation.Methods: Four focus groups were conducted with 20 staff working in mental health care services in the North West of the England using a topic guide. Focus groups involved 12 staff working in secondary care psychological services (7 participants in focus group 1 and 5 participants in focus group 4), 4 staff working in a rehabilitation unit (focus group 2), and 4 staff working in a community mental health team (focus group 3). Focus groups were transcribed verbatim, and transcripts were analyzed thematically to identify key themes that emerged from the data.Results: Four overarching themes, two with associated subthemes, were identified: (1) staff have conflicting views about the pros and cons of using Web-based resources and digital health interventions to manage mental health; (2) digital health interventions could increase access to mental health support options for severe mental health problems but may perpetuate the digital divide; (3) digital health interventions’ impact on staff roles and responsibilities; and (4) digital health interventions should be used to enhance, not replace, face-to-face support.Conclusions: This study is the first, to our knowledge, to qualitatively explore the experiences and attitudes of mental health care staff toward individuals with severe mental health problems using the Internet, mobile phones, and digital health interventions to self-manage their mental health. Understanding the positive and negative experiences and views shared by staff toward both current and potential digital health intervention use has enabled the identification of several considerations for implementation. Additionally, the findings suggest mental health care staff need clear guidance and training in relation to their responsibilities in recommending reputable and secure websites, forums, and digital health interventions and in how to manage professional boundaries on the Internet. Overall, the study highlights that digital health interventions could be well received by staff working in mental health services but importantly, such management options must be presented to frontline staff as an avenue to enhance care and extend choice, rather than as a method to reduce costs.
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- 2017
14. Comparing early signs and basic symptoms as methods for predicting psychotic relapse in clinical practice
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Eisner, Emily, Drake, Richard, Lobban, Fiona, Bucci, Sandra, Emsley, Richard, and Barrowclough, Christine
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Schizophrenia ,Early signs ,Relapse ,Basic symptoms ,Psychosis - Abstract
BackgroundEarly signs interventions show promise but could be further developed. A recent review suggested that ‘basic symptoms’ should be added to conventional early signs to improve relapse prediction. This study builds on preliminary evidence that basic symptoms predict relapse and aimed to: 1. examine which phenomena participants report prior to relapse and how they describe them; 2. determine the best way of identifying pre-relapse basic symptoms; 3. assess current practice by comparing self- and casenote-reported pre-relapse experiences.MethodsParticipants with non-affective psychosis were recruited from UK mental health services. In-depth interviews (n = 23), verbal checklists of basic symptoms (n = 23) and casenote extracts (n = 208) were analysed using directed content analysis and non-parametric statistical tests.ResultsThree-quarters of interviewees reported basic symptoms and all reported conventional early signs and ‘other’ pre-relapse experiences. Interviewees provided rich descriptions of basic symptoms. Verbal checklist interviews asking specifically about basic symptoms identified these experiences more readily than open questions during in-depth interviews. Only 5% of casenotes recorded basic symptoms; interviewees were 16 times more likely to report basic symptoms than their casenotes did.ConclusionsThe majority of interviewees self-reported pre-relapse basic symptoms when asked specifically about these experiences but very few casenotes reported these symptoms. Basic symptoms may be potent predictors of relapse that clinicians miss. A self-report measure would aid monitoring of basic symptoms in routine clinical practice and would facilitate a prospective investigation comparing basic symptoms and conventional early signs as predictors of relapse.
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- 2017
15. A Web-Based Intervention for Relatives of People Experiencing Psychosis or Bipolar Disorder: Design Study Using a User-Centered Approach
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Honary, Mahsa, Fisher, Naomi Ruth, McNaney, Roisin, and Lobban, Fiona
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caregivers ,Coping (psychology) ,020205 medical informatics ,Applied psychology ,02 engineering and technology ,03 medical and health sciences ,0302 clinical medicine ,Heuristic evaluation ,Computer literacy ,0202 electrical engineering, electronic engineering, information engineering ,Web application ,Confidentiality ,psychosis ,user-centered design ,User-centered design ,bipolar disorder ,Original Paper ,Web-based intervention ,business.industry ,Usability ,Mental health ,030227 psychiatry ,Psychiatry and Mental health ,business ,Psychology ,mental health - Abstract
BackgroundRelatives of people experiencing bipolar mood episodes or psychosis face a multitude of challenges (eg, social isolation, limited coping strategies, and issues with maintaining relationships). Despite this, there is limited informational and emotional support for people who find themselves in supporting or caring roles. Digital technologies provide us with an opportunity to offer accessible tools, which can be used flexibly to provide evidence-based information and support, allowing relatives to build their understanding of mental health problems and learn from others who have similar experiences. However, to design tools that are useful to relatives, we first need to understand their needs.ObjectiveThe aim of this study was to use a user-centered design approach to develop an accessible Web-based intervention, based on the Relatives Education And Coping Toolkit (REACT) booklet, to support the informational and emotional needs of relatives of people experiencing psychosis or bipolar disorder.MethodsWe engaged relatives of people with experiences of bipolar disorder or psychosis in workshops to identify their needs and design requirements for developing a Web-based version of a paper-based toolkit. We used a 2-phase qualitative approach to explore relatives’ views on content, design, and functionalities, which are considered to be engaging and useful in a Web-based intervention. In phase 1, we consulted 24 relatives in 2 workshops to better understand their existing support infrastructure, their barriers for accessing support, unmet needs, and relatives’ views on online support. On the basis of the results of these workshops, we developed a set of design considerations to be explored in a smaller workshop. Workshop 3 then involved working with 2 digitally literate relatives to design a usable and acceptable interface for our Web-based toolkit. Finally, in phase 2, we conducted a heuristic evaluation to assess the usability of the toolkit.ResultsOur findings indicated that relatives require technologies that (1) they can place their trust in, particularly when discussing a highly sensitive topic, (2) enable learning from the lived experiences of others while retaining confidentiality, and (3) they can work through at their own pace in a personalized manner.ConclusionsOur study highlights the need for providing a trustworthy, supportive tool where relatives can engage with people who have similar experiences to their own. Our heuristic evaluation showed promise in terms of perceived usability of the REACT Web-based intervention. Through this work, we emphasize the need to involve stakeholders with various characteristics, including users with limited computer literacy or experience in online support.
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- 2018
16. Attachment and therapeutic alliance in psychological therapy for people with recent onset psychosis who use cannabis.
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Berry, Katherine, Palmer, Tom, Gregg, Lynsey, Barrowclough, Christine, and Lobban, Fiona
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SUBSTANCE-induced psychoses ,AGE factors in disease ,ANXIETY ,ATTACHMENT behavior ,COGNITIVE therapy ,PHYSICIAN-patient relations ,SELF-evaluation ,RANDOMIZED controlled trials ,MOTIVATIONAL interviewing ,PATIENTS' attitudes ,PHYSICIANS' attitudes ,THERAPEUTICS - Abstract
We examine associations between client attachment style and therapeutic alliance in a 3‐arm randomized controlled trial of brief motivational interviewing and cognitive–behavioural therapy compared with longer term motivational interviewing and cognitive–behavioural therapy or standard care alone. Client self‐report measures of attachment style were completed at baseline, and both clients and therapists in the treatment arms of the trial completed alliance measures 1 month into therapy. We found that insecure–anxious attachment was positively associated with therapist‐rated alliance, whereas clients with insecure–avoidant attachment were more likely to report poorer bond with therapist. There was no evidence that client attachment significantly predicted clinical or substance misuse outcomes either directly or indirectly via alliance. Nor evidence that the length of therapy offered interacted with attachment to predict alliance. [ABSTRACT FROM AUTHOR]
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- 2018
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17. Acceptability of Interventions Delivered Online and Through Mobile Phones for People Who Experience Severe Mental Health Problems:A Systematic Review.
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Berry, Natalie, Lobban, Fiona, Emsley, Richard, Bucci, Sandra, and Berry, BSc (Hons), MSc, Natalie
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MENTAL health services ,TELEMEDICINE ,PATIENT participation ,HEALTH services accessibility ,CRISIS intervention (Mental health services) ,DEMOGRAPHIC characteristics ,SYSTEMATIC reviews ,COMPUTER network resources - Abstract
Background: Psychological interventions are recommended for people with severe mental health problems (SMI). However, barriers exist in the provision of these services and access is limited. Therefore, researchers are beginning to develop and deliver interventions online and via mobile phones. Previous research has indicated that interventions delivered in this format are acceptable for people with SMI. However, a comprehensive systematic review is needed to investigate the acceptability of online and mobile phone-delivered interventions for SMI in depth. Objective: This systematic review aimed to 1) identify the hypothetical acceptability (acceptability prior to or without the delivery of an intervention) and actual acceptability (acceptability where an intervention was delivered) of online and mobile phone-delivered interventions for SMI, 2) investigate the impact of factors such as demographic and clinical characteristics on acceptability, and 3) identify common participant views in qualitative studies that pinpoint factors influencing acceptability. Methods: We conducted a systematic search of the databases PubMed, Embase, PsycINFO, CINAHL, and Web of Science in April 2015, which yielded a total of 8017 search results, with 49 studies meeting the full inclusion criteria. Studies were included if they measured acceptability through participant views, module completion rates, or intervention use. Studies delivering interventions were included if the delivery method was online or via mobile phones. Results: The hypothetical acceptability of online and mobile phone-delivered interventions for SMI was relatively low, while actual acceptability tended to be high. Hypothetical acceptability was higher for interventions delivered via text messages than by emails. The majority of studies that assessed the impact of demographic characteristics on acceptability reported no significant relationships between the two. Additionally, actual acceptability was higher when participants were provided remote online support. Common qualitative factors relating to acceptability were safety and privacy concerns, the importance of an engaging and appealing delivery format, the inclusion of peer support, computer and mobile phone literacy, technical issues, and concerns about the impact of psychological state on intervention use. Conclusions: This systematic review provides an in-depth focus on the acceptability of online and mobile phone-delivered interventions for SMI and identified the need for further research in this area. Based on the results from this review, we recommend that researchers measure both hypothetical and actual acceptability to identify whether initial perceptions of online and mobile phone-delivered interventions change after access. In addition, more focus is needed on the potential impact of demographic and clinical characteristics on acceptability. The review also identified issues with module completion rates and intervention use as measures of acceptability. We therefore advise researchers to obtain qualitative reports of acceptability throughout each phase of intervention development and testing. Further implications and opportunities for future research are discussed. [ABSTRACT FROM AUTHOR]
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- 2016
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18. Friends interventions in psychosis: a narrative review and call to action.
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Harrop, Chris, Ellett, Lyn, Brand, Rachel, and Lobban, Fiona
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FRIENDSHIP ,PSYCHOSES ,OPERANT behavior ,PEERS ,YOUTH - Abstract
Aims To highlight the importance of friendships to young people with psychosis, and the need for clinical interventions to help maintain peer relationships during illness. To structure a research agenda for developing evidence-based interventions with friends. Method An argument is developed through a narrative review of (i) the proven efficacy of family interventions, and (by comparison) a relative absence of friend-based interventions; (ii) the particular primacy of friendships and dating for young people, and typical effects of exclusion; and (iii) reduced friendship networks and dating experiences in psychosis, in pre-, during and post-psychosis phases, also links between exclusion and psychosis. Results We put forward a model of how poor friendships can potentially be a causal and/or maintenance factor for psychotic symptoms. Given this model, our thesis is that interventions aiming to maintain social networks can be hugely beneficial clinically for young people with psychosis. We give a case study to show how such an intervention can work. Conclusions We call for 'friends interventions' for young people with psychosis to be developed, where professionals directly work with a young person's authentic social group to support key friendships and maintain social continuity. An agenda for future research is presented that will develop and test theoretically driven interventions. [ABSTRACT FROM AUTHOR]
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- 2015
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19. The Impact of Cannabis Use on Clinical Outcomes in Recent Onset Psychosis.
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Barrowclough, Christine, Gregg, Lynsey, Lobban, Fiona, Bucci, Sandra, and Emsley, Richard
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EVALUATION of medical care ,CANNABIS (Genus) ,LONGITUDINAL method ,PSYCHOLOGICAL tests ,PSYCHOSES ,RESEARCH funding ,SUBSTANCE abuse ,RANDOMIZED controlled trials ,REPEATED measures design - Abstract
Background: There are inconsistencies in findings as to whether cannabis use has a negative impact on clinical outcomes for people with established psychosis. Effects may be more evident on patients with recent onset psychosis. Aim: To investigate the relationship between cannabis use and clinical outcome, including whether change in cannabis use affects psychotic symptoms, affective symptoms, functioning and psychotic relapse in a sample of people in early psychosis with comorbid cannabis abuse or dependence. Methods: One hundred and ten participants were examined prospectively with repeated measures of substance use antecedent to psychopathology at baseline, 4.5, 9, and 18 months. We used random intercept models to estimate the effects of cannabis dose on subsequent clinical outcomes and whether change in cannabis use was associated with change in outcomes. Results: There was no evidence of a specific association between cannabis use and positive symptoms, or negative symptoms, relapse or hospital admissions. However, a greater dose of cannabis was associated with subsequent higher depression and anxiety. Change in the amount of cannabis used was associated with statistically significant corresponding change in anxiety scores, but not depression. Additionally, reductions in cannabis exposure were related to improved patient functioning. Conclusions: Reducing cannabis may be directly associated with improvements in anxiety and functioning, but not other specific symptoms. [ABSTRACT FROM PUBLISHER]
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- 2015
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20. What do relatives experience when supporting someone in early psychosis?
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Wainwright, Laura D., Glentworth, David, Haddock, Gillian, Bentley, Ros, and Lobban, Fiona
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PSYCHOLOGICAL adaptation ,CONTENT analysis ,EXPERIENCE ,FAMILIES ,FOCUS groups ,HEALTH services accessibility ,PSYCHOSES ,FAMILY relations ,SOCIAL support ,THEMATIC analysis ,PSYCHOLOGICAL factors - Abstract
Objectives In the United Kingdom ( UK), the government has set out priorities to support relatives and carers. Despite this, many relatives of people experiencing psychosis continue to feel unsupported by mental health services. This may be due to lack of funding, high caseloads for mental health professionals, or due to a lack of understanding of what relatives experience as a result of their family member's psychosis. This research aimed to explore relatives' experiences of supporting a relative in early psychosis. Design Thematic analysis was used to conduct an in-depth study of relatives' experiences of supporting a family member in early psychosis. Methods Eligible individuals were recruited via local National Health Service Early Intervention Teams and other carer support agencies. Four focus groups were conducted, each with a range of five to seven participants. Results Four key themes 'reflecting relatives' understanding and management of psychosis were identified: 'Psychosis from the relatives' perspective'; 'Relatives' fight with the mental health 'system'; 'Is anybody listening? Does anyone understand?'; and 'Relatives' coping'. Clinical implications of these themes are discussed. Conclusions This study has clear implications for improvement in how relatives are supported in the United Kingdom, such as; clearer guidance for staff about confidentiality, treating relatives as partners in care and providing better quality information for relatives. Practitioner points Continue to improve the Care Plan Approach process to include relatives as partners in care., Information available about psychosis needs to be clear and, where possible, clarify the processes and protocols by which services operate and how to access appropriate help., Move away from simplistic rules about confidentiality and formalise procedures to allow relatives and carers access to the information they need, without impeding service users' rights. For example, providing additional training for professionals such as Rethink's 'Carers and Confidentiality' online resource ()., Improved support, supervision and training are needed for staff to deal with relatives' distress and the impact of psychosis., Relatives' experiences of services is more positive in specialist Early Interventions Services for psychosis, than in other health service teams. [ABSTRACT FROM AUTHOR]
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- 2015
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21. Qualitative investigation of targets for and barriers to interventions to prevent psychosis relapse.
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Eisner, Emily, Barrowclough, Christine, Lobban, Fiona, and Drake, Richard
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Background: Early signs based relapse prevention interventions for psychosis show promise. In order to examine how they might be improved we sought to better understand the early relapse process, service users’ abilities to identify early signs, and any potential facilitators and barriers to early signs interventions. Methods: Data from in-depth interviews with a convenience sample of service users with psychosis varying in gender, age, duration of mental health problems, and time since last relapse were analysed using a thematic approach. Interview transcripts were coded inductively and relationships between emerging themes were examined by the research team to provide a thorough synthesis of the data. Results: Three central themes emerged from the analysis: 1) recognising risk factors (how risk factors were identified and linked to relapse, and reactions to such risk factors); 2) identifying early signs (issues related to both recognising and recalling signs of relapse); 3) reacting to deterioration (participants’ thoughts and feelings in response to early signs, including help seeking and its challenges). Conclusions: There was considerable variation in the attention participants had paid to pre-relapse signs, the ease with which they were able to recall them, and their reactions to them. For many, there were substantial barriers to help seeking from services. A family or friend confidant was an important means of assistance, although the supportive presence of significant others was not always available. Based on these results, a number of recommendations about facilitating service users’ recognition of early signs and targeting potential accelerants of relapse are made. [ABSTRACT FROM AUTHOR]
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- 2014
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22. A systematic review of randomised controlled trials of interventions reporting outcomes for relatives of people with psychosis
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Lobban, Fiona, Postlethwaite, Adam, Glentworth, David, Pinfold, Vanessa, Wainwright, Laura, Dunn, Graham, Clancy, Anna, and Haddock, Gillian
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PSYCHOSES , *HEALTH outcome assessment , *SYSTEMATIC reviews , *RANDOMIZED controlled trials , *CLINICAL psychology , *CONTROL groups , *RESEARCH methodology ,PSYCHIATRIC research - Abstract
Abstract: Relatives play a key role in supporting people with psychosis at all stages of recovery, but this can be associated with high levels of distress. Family interventions, with an international evidence base, improve outcomes for service users but little is known about their impact on relatives'' outcomes. This review of published evaluations aimed to assess whether family interventions are effective in improving outcomes for relatives of people with psychosis, to identify the key components of effective intervention packages, and to identify methodological limitations to be addressed in future research. Fifty studies were identified which evaluated an intervention to support relatives against a control group, and in which outcomes for the relatives were reported. Thirty (60%) studies showed a statistically significant positive impact of the intervention on at least one relatives'' outcome category. Eleven key intervention components were identified across all 50 studies, but there was no evidence that the presence or absence of any of these key components reliably distinguished effective from ineffective interventions. Methodological quality of studies was generally poor with only 11 studies rated as adequate using the Clinical Trial Assessment Measure (CTAM). Recommendations to improve future research include larger samples; better defined interventions and controls; true randomisation and blind assessors; clearly specified primary outcomes; pre-published analysis plans that account appropriately for missing data and clustering of data; a consensus on the most relevant outcomes to assess and valid and reliable measures to do so. Alternative research designs need to be considered to evaluate more recent approaches which focus on family support, personalised to meet individual need, and offered as an integral part of complex clinical services. [Copyright &y& Elsevier]
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- 2013
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23. Comparing early signs and basic symptoms as methods for predicting psychotic relapse in clinical practice.
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Eisner, Emily, Drake, Richard, Lobban, Fiona, Bucci, Sandra, Emsley, Richard, and Barrowclough, Christine
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PSYCHOSES , *PSYCHIATRIC treatment , *DISEASE relapse , *SELF-report inventories , *MENTAL health services , *CLINICAL trials , *DIAGNOSIS of schizophrenia , *COMPARATIVE studies , *RESEARCH methodology , *MEDICAL cooperation , *MENTAL status examination , *NONPARAMETRIC statistics , *RESEARCH , *SELF-evaluation , *EVALUATION research , *RESEARCH bias , *RECEIVER operating characteristic curves , *DIAGNOSIS - Abstract
Background: Early signs interventions show promise but could be further developed. A recent review suggested that 'basic symptoms' should be added to conventional early signs to improve relapse prediction. This study builds on preliminary evidence that basic symptoms predict relapse and aimed to: 1. examine which phenomena participants report prior to relapse and how they describe them; 2. determine the best way of identifying pre-relapse basic symptoms; 3. assess current practice by comparing self- and casenote-reported pre-relapse experiences.Methods: Participants with non-affective psychosis were recruited from UK mental health services. In-depth interviews (n=23), verbal checklists of basic symptoms (n=23) and casenote extracts (n=208) were analysed using directed content analysis and non-parametric statistical tests.Results: Three-quarters of interviewees reported basic symptoms and all reported conventional early signs and 'other' pre-relapse experiences. Interviewees provided rich descriptions of basic symptoms. Verbal checklist interviews asking specifically about basic symptoms identified these experiences more readily than open questions during in-depth interviews. Only 5% of casenotes recorded basic symptoms; interviewees were 16 times more likely to report basic symptoms than their casenotes did.Conclusions: The majority of interviewees self-reported pre-relapse basic symptoms when asked specifically about these experiences but very few casenotes reported these symptoms. Basic symptoms may be potent predictors of relapse that clinicians miss. A self-report measure would aid monitoring of basic symptoms in routine clinical practice and would facilitate a prospective investigation comparing basic symptoms and conventional early signs as predictors of relapse. [ABSTRACT FROM AUTHOR]- Published
- 2018
- Full Text
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24. The influence of positive affect on jumping to conclusions in delusional thinking
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Lee, Gary, Barrowclough, Christine, and Lobban, Fiona
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DELUSIONS , *THOUGHT & thinking , *DECISION making , *INFLUENCE , *PERFORMANCE evaluation , *SOCIAL context - Abstract
Abstract: This study examined relationships between positive affect and jumping to conclusions (JTC) in delusional thinking. One hundred and eighty-nine non-clinical participants entered an internet experiment and were randomized into one of two conditions. Those in a positive condition performed online creativity tasks and received bogus positive feedback as part of a positive affect induction procedure, whilst a neutral condition received neutral feedback. Both groups were subsequently assessed on a survey task for changes in JTC. In line with hypotheses, participants in the positive condition requested significantly more survey comments before drawing conclusions than those in the neutral condition. Results suggest that increases in positive affect may be linked with a tendency to gather more information before making decisions (i.e. a reduction in JTC). The influence of positive affect on reasoning biases in social environments is discussed. [Copyright &y& Elsevier]
- Published
- 2011
- Full Text
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25. Illness beliefs in schizophrenia
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Kinderman, Peter, Setzu, Erika, Lobban, Fiona, and Salmon, Peter
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HEALTH , *DISEASES , *MEDICAL care , *MENTAL illness , *DISABILITIES - Abstract
Abstract: Beliefs about health and illness shape emotional responses to illness, health-related behaviour and relationships with health-care providers in physical illness. Researchers are beginning to study the illness beliefs of people with psychosis, primarily using models developed in relation to physical illness. It is likely that modifications to these models will be necessary if they are to apply to mental disorders, and it is probable that some of the assumptions underlying the models will be inappropriate. In particular, different dimensions of understanding may be present in mental illness in comparison to those identified in physical illness. The present study examines the beliefs of 20 patients in the UK diagnosed with schizophrenia, including 10 currently psychotic inpatients and 10 outpatients in remission, about their experiences, using qualitative interviews and thematic analysis. Patients currently experiencing psychosis did not identify their experiences as separable ‘illnesses’ and did not have ‘illness beliefs’. Patients currently in a period of remission appraised their experiences as distinct from their own normal behaviour, but used conceptual frameworks of understanding that deviated significantly from conventional ‘health belief’ models. Patients’ ways of understanding mental illness did not parallel those described in physical illnesses. Methods for assessing beliefs about mental illness should therefore not be transferred directly from studies of beliefs about physical illness, but should be tailored to the nature of patients’ beliefs about mental illness. [Copyright &y& Elsevier]
- Published
- 2006
- Full Text
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