ECLIPSE Study 9: Building resilience and recovery through enhancing cognition and quality
Background and study aims
Non-affective psychosis is the name given to a group of mental health conditions in which a person suffers from psychosis that is not related to mood. Schizophrenia and delusional disorders are examples of non-affective psychoses. These disorders involve a wide range of symptoms, including seeing or hearing things that are not there (hallucinations), having beliefs that do not reflect reality (delusions) and distinct changes in personality or behaviour. These symptoms can be very difficult for patients to deal with, often affecting the way they live their lives and their ability to work. The extent of cognitive problems (problems with thought, learning and/or memory) in people with these conditions is a good predictor functional recovery (how well someone can function in life), even with the best possible rehabilitation opportunities and medication. A new psychological treatment known as cognitive remediation (CRT) can improve both cognitive and functional recovery, including social relationships, work and studying. The ideal time to provide CRT is when a patient is being seen by the Early Intervention Services (for young people experiencing psychosis for the first time, and during the first three years following this first episode) as it is well known that it is more effective for younger people and may have larger effects on functioning if the intervention happens at the earliest opportunity. The aim of this study is to investigate the best way of putting into effect CRT for people in Early Intervention Services by assessing the degree that participants are able to achieve their personal goals.
What does the study involve?
Participants are randomly allocated to one of four groups. Those in the first group take part in intensive CRT. This involves receiving twice weekly individual therapy sessions for ten and a half weeks. Each session lasts for 60-180 minutes and involves 20-60 minutes of CRT with the therapist, 20-60 minutes of work learning how to apply CRT strategies to real life, and 20-60 minutes of independent CRT, done by the patient in their own time. Those in the second group take part in group CRT. This involves taking part in hour long sessions three times a week for 14 weeks in groups of four. Those in the third group take part in independent CRT. This involves an initial individual session with a therapist to get started and then taking part in CRT on their own at home. These participants are supported through regular contact with their therapist in the form of telephone calls and drop in sessions. Those in the fourth group take receive standard therapy which involves receiving different therapies as deemed necessary by the treating team. At the start of the study, after the CRT programs are complete and then six months later, participants in all groups complete a number of questionnaires in order to evaluate how effective the treatment that they have received has been.
What are the possible benefits and risks of participating?
Participants benefit from receiving financial compensation for taking part in each of the research assessments (£7 per hour). Additionally, participants will have a 75% chance of being allocated to cognitive remediation therapy that may help their thinking skills and everyday activities. There are no notable risks involved with participating in this study.