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      Promoting Personal Recovery in People with Persisting Psychotic Disorders: Development and Pilot Study of a Novel Digital Intervention

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          Abstract

          Background

          For people with persisting psychotic disorders, personal recovery has become an important target of mental health services worldwide. Strongly influenced by mental health service consumer perspectives, personal recovery refers to being able to live a satisfying and contributing life irrespective of ongoing symptoms and disability. Contact with peers with shared lived experience is often cited as facilitative of recovery. We aimed to develop and pilot a novel recovery-based digitally supported intervention for people with a psychotic illness.

          Methods

          We developed a website to be used on a tablet computer by mental health workers to structure therapeutic discussions about personal recovery. Central to the site was a series of video interviews of people with lived experience of psychosis discussing how they had navigated issues within their own recovery based on the Connectedness–Hope–Identity–Meaning–Empowerment model of recovery. We examined the feasibility and acceptability of an 8-session low intensity intervention using this site in 10 participants with persisting psychotic disorders and conducted a proof-of-concept analysis of outcomes.

          Results

          All 10 participants completed the full course of sessions, and it was possible to integrate use of the website into nearly all sessions. Participant feedback confirmed that use of the website was a feasible and acceptable way of working. All participants stated that they would recommend the intervention to others. Post-intervention, personal recovery measured by the Questionnaire for the Process of Recovery had improved by an average standardized effect of d = 0.46, 95% CI [0.07, 0.84], and 8 of the 10 participants reported that their mental health had improved since taking part in the intervention.

          Conclusion

          In-session use of digital resources featuring peer accounts of recovery is feasible and acceptable and shows promising outcomes. A randomized controlled trial is the next step in evaluating the efficacy of this low intensity intervention when delivered in conjunction with routine mental health care.

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          Most cited references23

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          People living with psychotic illness in 2010: the second Australian national survey of psychosis.

          The 2010 Survey of High Impact Psychosis (SHIP) is Australia's second national psychosis survey. This paper provides an overview of its findings, including comparisons with the first psychosis survey and general population data. The survey covered 1.5 million people aged 18-64 years, approximately 10% of Australians in this age group. A two-phase design was used. In phase 1, screening for psychosis took place in public mental health services and non-government organizations supporting people with mental illness. In phase 2, 1825 of those screen-positive for psychosis were randomly selected and interviewed. Data collected included symptomatology, substance use, functioning, service utilization, medication use, education, employment, housing, and physical health including fasting blood samples. The estimated 1-month treated prevalence of psychotic disorders in public treatment services was 3.1 people per 1000 population; the 12-month treated prevalence was 4.5 people per 1000. The majority (63.0%) of participants met ICD-10 criteria for schizophrenia/schizoaffective disorder. One-half (49.5%) reported attempting suicide in their lifetime and two-thirds (63.2%) were rated as impaired in their ability to socialize. Over half (54.8%) had metabolic syndrome. The proportion currently smoking was 66.1%. Educational achievement was low. Only 21.5% were currently employed. Key changes in the 12 years since the first survey included: a marked drop in psychiatric inpatient admissions; a large increase in the proportion attending community mental health clinics; increased use of rehabilitation services and non-government organizations supporting people with mental illness; a major shift from typical to atypical antipsychotics; and large increases in the proportions with lifetime alcohol or drug abuse/dependence. People with psychotic illness face multiple challenges. An integrated approach to service provision is needed to ensure that their living requirements and needs for social participation are met, in addition to their very considerable mental and physical health needs.
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            The questionnaire about the process of recovery (QPR): A measurement tool developed in collaboration with service users

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              Measuring Social Isolation in Older Adults: Development and Initial Validation of the Friendship Scale

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                Author and article information

                Contributors
                Journal
                Front Psychiatry
                Front Psychiatry
                Front. Psychiatry
                Frontiers in Psychiatry
                Frontiers Media S.A.
                1664-0640
                23 December 2016
                2016
                : 7
                : 196
                Affiliations
                [1] 1Centre for Mental Health, Swinburne University of Technology , Hawthorn, VIC, Australia
                [2] 2Monash Alfred Psychiatry Research Centre, Monash University and The Alfred , Melbourne, VIC, Australia
                [3] 3Department of Psychology and Counselling, La Trobe University , Melbourne, VIC, Australia
                [4] 4NorthWestern Mental Health, Royal Melbourne Hospital , Melbourne, VIC, Australia
                [5] 5Wellways Australia , Melbourne, VIC, Australia
                [6] 6Department of Psychiatry, St Vincent’s Hospital , Fitzroy, VIC, Australia
                [7] 7Centre for Design Innovation, Swinburne University of Technology , Hawthorn, VIC, Australia
                [8] 8Department of Computing and Information Systems, University of Melbourne , Parkville, VIC, Australia
                [9] 9Department of Psychiatry, University of Melbourne , Parkville, VIC, Australia
                [10] 10Research School of Psychology, Australian National University , Canberra, ACT, Australia
                Author notes

                Edited by: Jérôme Favrod, University of Applied Sciences and Arts of Western Switzerland, Switzerland

                Reviewed by: Karsten Heekeren, University of Zurich, Switzerland; Kim T. Mueser, Boston University, USA

                *Correspondence: Neil Thomas, neilthomas@ 123456swin.edu.au

                Specialty section: This article was submitted to Public Mental Health, a section of the journal Frontiers in Psychiatry

                Article
                10.3389/fpsyt.2016.00196
                5179552
                28066271
                956e5041-3478-4890-8165-982f7a713041
                Copyright © 2016 Thomas, Farhall, Foley, Leitan, Villagonzalo, Ladd, Nunan, Farnan, Frankish, Smark, Rossell, Sterling, Murray, Castle and Kyrios.

                This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

                History
                : 19 September 2016
                : 25 November 2016
                Page count
                Figures: 2, Tables: 4, Equations: 0, References: 49, Pages: 12, Words: 9558
                Funding
                Funded by: Department of Health, State Government of Victoria 10.13039/501100003747
                Award ID: MIRF33
                Categories
                Psychiatry
                Original Research

                Clinical Psychology & Psychiatry
                schizophrenia,psychosis,personal recovery,mental health services,low intensity interventions,digital health,tablet computers,peer support

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