DEcision-making Capacity: Intervention Development & Evaluation in Schizophrenia-spectrum Disorder (DEC:IDES)
Schizophrenia and Related Disorders, Mental Competency
About this trial
This is an interventional other trial for Schizophrenia and Related Disorders focused on measuring schizophrenia, psychosis, umbrella trial, decision-making capacity, self-esteem, self-stigma, jumping to conclusions
Eligibility Criteria
Inclusion Criteria:
- aged between 18 and 65 years;
- able to be interviewed and complete the measures;
- diagnosed with a schizophrenia-spectrum disorder (schizophrenia, schizoaffective disorder, delusional disorder, psychosis not otherwise specified, brief psychotic disorder);
- presumed or already judged to have impaired treatment decision-making capacity;
- registered as patient with clinical or social care services
Exclusion Criteria:
- have a moderate to severe learning disability;
- have psychosis of a predominantly organic origin (e.g. brain injury, physical health condition, epilepsy) or have a primary diagnosis of substance or alcohol use disorder;
- cannot understand English sufficiently to engage in conversation without an interpreter;
- presents with a level of risk to others, including the researchers, that cannot be managed feasibility via suitable adjustments, as judged by Chief Investigator
Sites / Locations
- Pennine Care NHS Foundation Trust
- Lancashire and South Cumbria NHS Foundation Trust
- NHS LothianRecruiting
Arms of the Study
Arm 1
Arm 2
Arm 3
Arm 4
Arm 5
Arm 6
Experimental
Placebo Comparator
Experimental
Placebo Comparator
Experimental
Placebo Comparator
Self-esteem intervention
Self-esteem control group
Self-stigma intervention
Self-stigma control group
Jumping to conclusions intervention group
Jumping to conclusions control group
The self-esteem intervention involves 6 x 1-hour therapy sessions, each of which will be provided by a fully trained and supervised psychological therapist over an 8-week period (to allow for cancelled appointments etc). It will involve the following elements: Engagement and listening Positive regard and empathy Collaboration Development of a shared understanding of low self-esteem (a 'psychological formulation') Provision of written or audio-visual information relating to low self-esteem Between-session activity for participant Provision of structured self-help material relating to low self-esteem Testing of beliefs related to low self-esteem Practicing new strategies related to low self-esteem Development of a shared plan to maintain gains in self-esteem
'Assessment and support' for participants with low self-esteem will also involve 6 x 1-hour sessions with a psychological therapist, over a period of 8 weeks. However, in these meetings, the therapist will work in collaboration with the person to complete a more detailed assessment of factors which help or hinder their decision-making capacity. They will provide engagement, listening, positive regard and empathy, but they will not develop a psychological formulation, nor will they provide the person with information relating to their problems. They will also not provide self-help material, or encourage the person to test their beliefs, practice new strategies or develop a shared plan for the future. Once the trial is over, however, the therapist will offer to meet with the person to share the results of the assessment and develop a psychological formulation. With the participant's consent, this information will also be shared with the clinical team.
The self-stigma intervention involves 6 x 1-hour therapy sessions, each of which will be provided by a fully trained and supervised psychological therapist over an 8-week period (to allow for cancelled appointments etc). It will involve the following elements: Engagement and listening Positive regard and empathy Collaboration Development of a shared understanding of high self-stigma (a 'psychological formulation') Provision of written or audio-visual information relating to self-stigma Between-session activity for participant Provision of structured self-help material relating to self-stigma Testing of beliefs related to self-stigma Practicing new strategies related to self-stigma Development of a shared plan to maintain reductions in self-stigma
'Assessment and support' for participants with high self-stigma will also involve 6 x 1-hour sessions with a psychological therapist, over a period of 8 weeks. However, in these meetings, the therapist will work in collaboration with the person to complete a more detailed assessment of factors which help or hinder their decision-making capacity. They will provide engagement, listening, positive regard and empathy, but they will not develop a psychological formulation, nor will they provide the person with information relating to their problems. They will also not provide self-help material, or encourage the person to test their beliefs, practice new strategies or develop a shared plan for the future. Once the trial is over, however, the therapist will offer to meet with the person to share the results of the assessment and develop a psychological formulation. With the participant's consent, this information will also be shared with the clinical team.
The 'jumping-to conclusions' (JTC) intervention involves 6 x 1-hour therapy sessions, each of which will be provided by a fully trained and supervised psychological therapist over an 8-week period (to allow for cancelled appointments etc). It will involve the following elements: Engagement and listening Positive regard and empathy Collaboration Development of a shared understanding of role of JTC (a 'psychological formulation') Provision of written or audio-visual information relating to JTC Between-session activity for participant Provision of structured self-help material relating to JTC Testing of beliefs related to JTC Practicing new strategies related to reducing JTC Development of a shared plan to maintain reductions in JTC
'Assessment and support' for participants who demonstrate the JTC bias will also involve 6 x 1-hour sessions with a psychological therapist, over a period of 8 weeks. However, in these meetings, the therapist will work in collaboration with the person to complete a more detailed assessment of factors which help or hinder their decision-making capacity. They will provide engagement, listening, positive regard and empathy, but they will not develop a psychological formulation, nor will they provide the person with information relating to their problems. They will also not provide self-help material, or encourage the person to test their beliefs, practice new strategies or develop a shared plan for the future. Once the trial is over, however, the therapist will offer to meet with the person to share the results of the assessment and develop a psychological formulation. With the participant's consent, this information will also be shared with the clinical team.