Promoting Personal Recovery in People with Persisting Psychotic Disorders: Development and Pilot Study of a Novel Digital Intervention

Neil Thomas; John Farhall; Fiona Foley; Nuwan Dominic Leitan; Kristi-Ann Villagonzalo; Emma Ladd; Cassy Nunan; Sue Farnan; Rosalie Frankish; Tara Smark; Susan L Rossell; Leon Sterling; Greg Murray; David Jonathon Castle; Michael Kyrios

doi:10.3389/fpsyt.2016.00196

Promoting Personal Recovery in People with Persisting Psychotic Disorders: Development and Pilot Study of a Novel Digital Intervention

Front Psychiatry. 2016 Dec 23:7:196. doi: 10.3389/fpsyt.2016.00196. eCollection 2016.

Authors

Affiliations

¹ Centre for Mental Health, Swinburne University of Technology, Hawthorn, VIC, Australia; Monash Alfred Psychiatry Research Centre, Monash University and The Alfred, Melbourne, VIC, Australia.
² Department of Psychology and Counselling, La Trobe University, Melbourne, VIC, Australia; NorthWestern Mental Health, Royal Melbourne Hospital, Melbourne, VIC, Australia.
³ Centre for Mental Health, Swinburne University of Technology , Hawthorn, VIC , Australia.
⁴ Wellways Australia , Melbourne, VIC , Australia.
⁵ Centre for Mental Health, Swinburne University of Technology, Hawthorn, VIC, Australia; Monash Alfred Psychiatry Research Centre, Monash University and The Alfred, Melbourne, VIC, Australia; Department of Psychiatry, St Vincent's Hospital, Fitzroy, VIC, Australia.
⁶ Centre for Design Innovation, Swinburne University of Technology, Hawthorn, VIC, Australia; Department of Computing and Information Systems, University of Melbourne, Parkville, VIC, Australia.
⁷ Department of Psychiatry, St Vincent's Hospital, Fitzroy, VIC, Australia; Department of Psychiatry, University of Melbourne, Parkville, VIC, Australia.
⁸ Centre for Mental Health, Swinburne University of Technology, Hawthorn, VIC, Australia; Research School of Psychology, Australian National University, Canberra, ACT, Australia.

Abstract

Background: For people with persisting psychotic disorders, personal recovery has become an important target of mental health services worldwide. Strongly influenced by mental health service consumer perspectives, personal recovery refers to being able to live a satisfying and contributing life irrespective of ongoing symptoms and disability. Contact with peers with shared lived experience is often cited as facilitative of recovery. We aimed to develop and pilot a novel recovery-based digitally supported intervention for people with a psychotic illness.

Methods: We developed a website to be used on a tablet computer by mental health workers to structure therapeutic discussions about personal recovery. Central to the site was a series of video interviews of people with lived experience of psychosis discussing how they had navigated issues within their own recovery based on the Connectedness-Hope-Identity-Meaning-Empowerment model of recovery. We examined the feasibility and acceptability of an 8-session low intensity intervention using this site in 10 participants with persisting psychotic disorders and conducted a proof-of-concept analysis of outcomes.

Results: All 10 participants completed the full course of sessions, and it was possible to integrate use of the website into nearly all sessions. Participant feedback confirmed that use of the website was a feasible and acceptable way of working. All participants stated that they would recommend the intervention to others. Post-intervention, personal recovery measured by the Questionnaire for the Process of Recovery had improved by an average standardized effect of d = 0.46, 95% CI [0.07, 0.84], and 8 of the 10 participants reported that their mental health had improved since taking part in the intervention.

Conclusion: In-session use of digital resources featuring peer accounts of recovery is feasible and acceptable and shows promising outcomes. A randomized controlled trial is the next step in evaluating the efficacy of this low intensity intervention when delivered in conjunction with routine mental health care.

Keywords: digital health; low intensity interventions; mental health services; peer support; personal recovery; psychosis; schizophrenia; tablet computers.