Robin Owen
Betsi Cadwaladr University Health Board
Project Background:
Early Intervention in Psychosis (EIP) services are known to improve outcomes for young people by reducing relapse rates and improving quality of life.
EIP services offer a range of therapeutic interventions to achieve these outcomes, including group-based therapy.
Historical uptake of group therapy for young people with psychosis has been low in North Wales.
Stakeholder consultation with service-users and front line staff indicated that problems with travel and transport were amongst the primary causes of low uptake of group therapy.
The Values Programme Online:
Following consultation with service users and staff, we developed an online protocol to deliver a therapy based on Acceptance and Commitment Therapy for Psychosis (ACTp). This was a 4 session intervention delivered for two hours per session for four consecutive weeks.
Project Aims and Objectives:
Our primary aim was to increase access to evidence-based therapy for young people with psychosis. This informed our three project objectives:
- To increase the amount of young people with psychosis attending group therapy.
- To explore the acceptability of delivering group therapy online to young people with psychosis.
- To explore the feasibility (with respect to the service) of delivering group therapy online to young people with psychosis.
Increasing Access:
The Values Programme Online appears to be an effective method of increasing uptake of group therapy amongst young people with psychosis.
The graph below (Figure 2.0) demonstrates a significant improvement in uptake as represented as a percentage of the EIP service caseload.
The graph demonstrates a stepped increase in percentage uptake once the Values Programme Online was introduced.
Acceptability:
Semi-structured interviews with service users helped us to explore the acceptability of this approach.
Service-users reflected that participating in the group online felt ‘comfortable’ and reduced a sense of anxiety that could otherwise interfere with group attendance. These experiences indicated that online group therapy was acceptable to our service users.
Feasibility:
Clinicians who delivered the therapy found the protocol useful and enjoyed delivering the group.
Delivering therapy online reduced costs associated with travelling and saved on clinician time. In addition, travelling costs to service-users were also negated.
Co-produced reflections:
Although online delivery was acceptable to service users, some expressed a desire for a hybrid approach.
Most service users reported a willingness to travel 20 minutes for a ‘Goldilocks’ distance (please see figure 3.0) to attend a supplementary face-to-face session.
However, given the average distance from service user location (based on postcodes) to a central location, this would not be practical for the majority.
Conclusions:
The Values Programme Online appears to be an acceptable and feasible method of increasing access to group-based therapy for young people with psychosis.
It may be that a hybrid approach combining face to face and online modalities may increase acceptability to a broader range of service users. Incorporating this approach warrants further exploration in the future.
