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Randomized Controlled Trial
. 2023 Sep;96(3):560-576.
doi: 10.1111/papt.12456. Epub 2023 Mar 1.

Acceptability of a novel suicide prevention psychological therapy for people who experience non-affective psychosis

Kamelia Harris  1   2   3 , Patricia A Gooding  1   2   3 , Yvonne Awenat  1   2   3 , Gillian Haddock  1   2   3 , Leanne Cook  1   2   3 , Charlotte Huggett  1   2   3 , Steven Jones  4   5 , Fiona Lobban  4   5 , Ellen Peeney  1   2 , Daniel Pratt  1   2   3 , Sarah Peters  1   2   6
Affiliations
Randomized Controlled Trial

Acceptability of a novel suicide prevention psychological therapy for people who experience non-affective psychosis

Kamelia Harris et al. Psychol Psychother. 2023 Sep.

Abstract

Objectives: Suicide is a leading cause of death worldwide. People experiencing psychosis are at increased risk of death by suicide. Talking therapies can alleviate suicidal thoughts, plans, and attempts. Therapies need to also be acceptable to recipients. The aim of this study was to investigate the views on psychological therapy for people experiencing psychosis and suicidality using the Theoretical Framework of Acceptability.

Design: Qualitative interview study.

Methods: Participants were recruited from a randomised controlled trial comparing suicide prevention psychological therapy with treatment as usual. Individuals had a diagnosis of non-affective psychosis and experience of suicidal thoughts, plans and/or attempts. To assess the acceptability of the therapy, semi-structured interviews were conducted with 20 participants randomised to receive therapy. Data were deductively analysed using an adaptation of the Theoretical Framework of Acceptability.

Results: Interviews (Mean = 45 min) were conducted and audio recorded with 21 participants. Data were organised into six themes: 1. Affective attitude, 2. Burden, 3. Alliance, 4. Intervention coherence, 5. Perceived effectiveness, and 6. Self-efficacy. There was no evidence of issues relating to domains of ethicality and opportunity costs associated with receiving therapy.

Conclusions: Talking about suicide was difficult and, at times, distressing, but it was perceived to be useful for understanding experiences. To be acceptable, it is important for therapists to ensure that clients' understanding of therapy aligns with expectations of effectiveness and to invest in building strong therapeutic alliances. Future research will benefit from examining therapists' experiences of delivering therapy through different modes (e.g. online, telephone).

Keywords: acceptability; cognitive behavioural therapy; intervention; psychological therapy; psychosis; qualitative study; suicidality; suicide.

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Conflict of interest statement

All authors were principal investigators and co‐investigators in the trial. Some of the co‐authors were employed as research assistants or project coordinators on the trial.

Figures

FIGURE 1
FIGURE 1
Original Theoretical Framework of Acceptability (Sekhon et al., 2017).
FIGURE 2
FIGURE 2
Adapted Theoretical Framework of Acceptability applied to CBSPp.
See this image and copyright information in PMC

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