Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2023 Sep;62(3):621-641.
doi: 10.1111/bjc.12433. Epub 2023 Jun 25.

Attachment-focused iMAgery therapy for PSychosis (A-iMAPS): A case series targeting psychosis-related trauma

Nicola D Airey  1   2 , Katherine Berry  1   2 , Christopher D J Taylor  1   3
Affiliations

Attachment-focused iMAgery therapy for PSychosis (A-iMAPS): A case series targeting psychosis-related trauma

Nicola D Airey et al. Br J Clin Psychol. 2023 Sep.

Abstract

Objectives: The experience of psychosis and its sequelae (including treatment experiences) can be traumatic and affect feelings of safety and security. Until relatively recently, trauma therapy has been avoided with psychosis populations due to concerns about additional harm. Intervention-based research is growing, but focus on psychosis-related trauma is limited. Engendering psychological safety may support engagement with trauma-focused therapy, for which attachment theory provides a strong foundation. Imagery can enhance felt security and is an effective modality for working with trauma. Therefore, this study aimed to examine feasibility and preliminary outcomes of a novel attachment-focused imagery therapy (A-iMAPS) addressing psychosis-related trauma.

Methods: A multiple baseline case series: Participants received between two and five baseline assessments then engaged in the six-session A-iMAPS intervention. Participants completed weekly measures of trauma symptoms and felt security. Further measures were completed pre- and post-intervention.

Results: Twelve clinical participants were recruited from NHS services in Northwest England and eight retained through baseline and intervention to the end-of-therapy assessment (attending all sessions). A significant improvement was seen for felt security between baseline and intervention phases. Other measures of trauma symptoms, core schemas, paranoia and attachment varied in change from baseline to end of therapy, but some promising preliminary results were seen.

Conclusions: This study shows that a brief attachment-focused imagery therapy is a promising intervention for targeting psychosis-related trauma, for which there are currently no other specific intervention studies. Utilizing an attachment-informed framework when working with trauma in psychosis should be considered in future intervention studies.

Keywords: attachment; imagery; psychosis; therapy; trauma.

PubMed Disclaimer

References

REFERENCES

    1. Ainsworth, M. S. (1979). Infant-mother attachment. American Psychologist, 34(10), 932-937. https://doi.org/10.1037/0003-066X.34.10.932
    1. Airey, N. D., Taylor, C. D. J., Vikram, A., & Berry, K. (2023). Trauma measures for use with psychosis populations: A systematic review of psychometric properties using COSMIN. Psychiatry Research, 323, 115163. https://doi.org/10.1016/j.psychres.2023.115163
    1. Bailey, T., Alvarez-Jimenez, M., Garcia-Sanchez, A. M., Hulbert, C., Barlow, E., & Bendall, S. (2018). Childhood trauma is associated with severity of hallucinations and delusions in psychotic disorders: A systematic review and meta-analysis. Schizophrenia Bulletin, 44(5), 1111-1122. https://doi.org/10.1093/schbul/sbx161
    1. Barazzone, N., Santos, I., McGowan, J., & Donaghay-Spire, E. (2019). The links between adult attachment and post-traumatic stress: A systematic review. Psychology and Psychotherapy: Theory, Research and Practice, 92(1), 131-147. https://doi.org/10.1111/papt.12181
    1. Beards, S., Gayer-Anderson, C., Borges, S., Dewey, M. E., Fisher, H. L., & Morgan, C. (2013). Life events and psychosis: A review and meta-analysis. Schizophrenia Bulletin, 39(4), 740-747. https://doi.org/10.1093/schbul/sbt065

LinkOut - more resources