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A novel CBT informed intervention for social anxiety in people recovering from psychosis. Ruth Turner, Richard White, Rebecca Lower, Lina Gega, David Fowler. Acknowledgements.
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A novel CBT informed intervention for social anxiety in people recovering from psychosis. Ruth Turner, Richard White,Rebecca Lower, Lina Gega, David Fowler
Acknowledgements • Everyone who has helped to make the Social Anxiety Research Clinic successful: Tony Reilly,Timothy Clarke, Felicity Waite, Evelina Medin, Kevin Lloyd, Rose Christopher, Emily Drake all of our participants,and the case managers within Central Norfolk Early Intervention Team
Social Anxiety Research Clinic • Describe participants • Brief description of intervention • Describe findings • Discussion of use of virtual environments
Background • Up to 70% of people recovering from psychosis experience social anxiety. • This is a significant barrier to social recovery. • Social anxiety appears to be independent of the experience of positive symptoms
Description of sample at baseline • Demographics: ; 17 male, 5 female; Average age = 26 (S.D. 6) • PANSS (data for 13 participants) average score on positive sub-scale = 10.9 (S.D. = 3.0). 46% (n = 6) of participants scored 4 or more on one or more items of the sub-scale. • BDI average score = 26.6 (S.D. 15.8) • SIAS:
Description of sample at baseline SSI BCSS
Formulation Based on Clarke and Wells model
Intervention • The intervention is an assisted self-help intervention which follows four stages: • first stage included an assessment of social anxiety, goal setting and psycho-education about social anxiety. • Stage two helped patients develop an individualised CBT formulation. Patients identified their own idiosyncratic safety behaviours. • Stage three involved repeated exposure to anxiety provoking social situations in the format of behavioural experiments • The final stage focussed on maximising patients’ gains by planning further exposure-based behavioural experiments which were done either independently by the patient or with support from the care team. • Additional interventions were piloted using computerised cognitive bias modification and virtual environments.
Outcomes - SIAS • Baseline SIAS scores were compared to those at the 12, 18 and 24 week follow up points.
Additional pilot interventions • Preliminary evidence that CBM-I sentence completion task can be used to train a more positive interpretation bias in this group. • Virtual environments are being used to provide additional situations in which behavioural experiments can be conducted.
Conclusions • Preliminary evidence that an assisted self-help intervention may help to reduce the level of social anxiety in people recovering from psychosis. • Psychoeducation about social anxiety and the active engagement in behavioural experiments seems to be key.
Any questions? • Ruth.turner@nwmhp.nhs.uk