Is there a choice to make? A pilot study investigating attitudes towards treatment in an Early Intervention for Psychosis service
| DOI | https://doi.org/10.1108/MHRJ-09-2017-0038 |
| Date | 11 June 2018 |
| Pages | 110-120 |
| Published date | 11 June 2018 |
| Author | Felicity Ann Cowdrey,Lorna Hogg,Kate Chapman |
| Subject Matter | Health & social care,Mental health |
Is there a choice to make? A pilot study
investigating attitudes towards treatment
in an Early Intervention for
Psychosis service
Felicity Ann Cowdrey, Lorna Hogg and Kate Chapman
Abstract
Purpose –The purpose of this paper is to investigate health care professionals’(HCPs) and service-users’
(SUs) attitudes towards different treatment options in an Early Intervention for Psychosis (EIP) service as well
as the topical issue of offering choice over treatment.
Design/methodology/approach –Seven SUs accessing an EIP service and nine HCPs completed
qualitative surveys about treatment for psychosis. Data were analysed thematically.
Findings –Both HCPs and SUs appeared to have a generally positive attitude to the range of interventions
offered by the EIP service and SUs talked about the importance of all treatment optionsbeing explored. There
was variation in attitudes towards SUs having choice over their treatment and a number of factors were
identified as crucial in influencing attitudes including mental capacity, risk and level of engagement.
Research limitations/implications –Small sample size, recruitment from only one EIP service and using
a survey design limit generalisability and depth of analysis.
Practical implications –HCPs working in EIP services should explore different treatment options fully with
SUs but be aware that they may feel unable to make the decision themselves. Such discussions should be
revisited throughout an individual’s care as their ability and desire to make informed choices may change over
time. Continuing Professional Development and clinical supervision should be used to help HCPs reflect on
the choice agenda and the implications of this for clinical practice.
Originality/value –Fewstudies have examined attitudestowards treatmentsfor psychosis. Thisis an evolving
and importantclinical area that remains underresearched. Recommendationsfor service-development,future
research and clinicalpractice are made.
Keywords CBT, Psychosis, Antipsychotics, Shared decision making, Early intervention, Service-development
Paper type Research paper
Background
Early Interventionfor Psychosis (EIP) servicesaim to identify and engage people with a firstepisode
of psychosis as early as possible to ensure timely access to evidence-based interventions and
increasethe likelihood of symptomaticand functional recovery. TheUK’s Access and Waiting Time
Standards for MentalHealth Services specify that morethan 50 per cent of people experiencing a
first episodeof psychosis should be treatedwith a National Institute for Healthand Care Excellence
(NICE) approvedcare package within two weeks of referral (NHS England,2015). NICE guidelines
state that EIPservices should aim to provide a fullrange of pharmacological, psychological, social,
occupational and educational interventions to service-users (SUs) and that oral antipsychotic
medication should be offered in conjunction with psychological intervention for people with first
episode psychosis(National Institute for Clinical Excellence, 2014). For those considered to be at
increased risk of developing psychosis, psychological therapy withoutantipsychotic medication is
recommended as the front line intervention.
Received 17 October 2017
Revised 10 March 2018
Accepted 26 March 2018
The authors report no conflicts of
interest. No external funding was
received for this study. The
authors are grateful to the service-
users and staff who completed the
survey.
Felicity Ann Cowdrey is a
Clinical Psychologist at
Cotswold House, Specialist
Eating Disorder Unit, Oxford
Health NHS Foundation Trust,
Marlborough, UK; and at the
Clinical Psychology
Department, University of Bath,
Bath, UK.
Lorna Hogg is a Lecturer at the
Clinical Psychology
Department, University of Bath,
Bath, UK.
Kate Chapman is a Clinical
Psychologist at South
Gloucestershire Early
Intervention for Psychosis
Service, Avon and Wiltshire
Mental Health Partnership NHS
Trust, Bristol, UK.
PAGE110
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MENTALHEALTH REVIEW JOURNAL
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VOL. 23 NO. 2 2018, pp. 110-120, © Emerald Publishing Limited, ISSN 1361-9322 DOI 10.1108/MHRJ-09-2017-0038
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