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PhD Studentship - Orfanos

Centre for Psychiatry

Funding Body: East London NHS Foundation Trust
Project Investigator: Stefan Priebe

Overview

In the UK, many mental health services rely heavily on group treatments in the care of individuals with schizophrenia; including ’activity groups’, ’support groups’, ’problem-solving/psycho-educational groups’, and ’psychodynamic groups’. However, whilst a number of studies suggest that these group treatments are effective for individuals with schizophrenia, little is understood about how these interventions work.

Critically, very little research has identified and explored group processes which are currently vaguely defined as action mechanisms inherent to group dynamics and interaction that contribute to therapeutic change. At present, it is unclear whether interactions between patients in group therapies, and/or perceived benefits of the group format are beneficial for individuals with schizophrenia.

In particular, it is unclear whether these processes are specific for a particular group approach or are shared across all group therapies for schizophrenia.

The proposed project therefore aims to identify group therapeutic processes using both observer-ratings of interactive behaviour (nonverbal and verbal communicative behaviours) and patient-reported experiences of group interactions across verbal (CBT oriented) and nonverbal (Body Psychotherapy, BPT) group therapies. These identified processes will then be linked with improvements in therapeutic outcomes.

Activities & Outputs

The proposed project will be an exploratory prospective longitudinal study, consisting of four parts. First, the proposed project aims to systematically review literature on

  • the effectiveness of group therapies for patients with schizophrenia and
  • components and measures of group interaction in a mental health population.

Second, interaction between group members will be measured from video recordings of five groups of Body Psychotherapy and two groups of Cognitive Behavioural Therapy (oriented) groups. Data on group Body Psychotherapy will be from a HTA funded multi-centred randomised controlled trial (1).
Third, data on patient reported experiences of group interactions will be collected from in-depth interviews of the patients attending the video recorded groups.

Finally, regression analysis will be employed to assess whether these identified group therapeutic processes can be linked

  • to each other,
  • with changes in negative symptoms (primary outcome) and with a range of secondary outcomes (including positive and general symptoms, quality of life, treatment satisfaction, social contact with friends and family, and extra-pyramidal symptoms.

Outcomes from the proposed research project will help improve the effectiveness of routinely administered group psychotherapeutic interventions offered to individuals with schizophrenia.

The anticipated findings will give insight into

  • the interactive conditions in which group therapy for schizophrenia is preferable, and
  • what interactive group processes predict successful outcomes.
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