Authors: Max Birchwood, UK
Event: 2015 TheMHS Summer Forum
Subject: THEMHS SUMMER FORUM, MEN'S MENTAL HEALTH, YOUNG MEN WITH PSYCHOSIS, NEET STATUS, CBT INTERVENTION, COGNITIVE BEHAVIORAL TREATMENT
Type of resource: Audio
Abstract: In this lecture I will present an overview of effective and potentially effective interventions of particular relevance for young males with psychosis, arising from my first lecture. Vocational recovery is a key target. Individual placement and support (IPS) is a method of supporting fast (re-) entry to the work force with good evidence for employment outcomes in early psychosis. A recent trial in London and Birmingham showed that it is important to challenge clinicians’ sometime conservative views about the potential harm of employment on psychosis, which affects the motivation of clients to engage in pathways to employment and ultimately employment itself.
However, many young men with psychosis show very low levels of constructive activity in our measure of time use, which persists over the first 12 months of psychosis (the ‘low stable’ group) and can present a barrier to overcoming NEET status. Such individuals were found also to present with higher levels of depression and hopelessness with more positive and negative symptoms and lower service engagement. We developed a CBT intervention for this treatment reluctant and resistant group of young males using motivational interviewing, activity scheduling and management of depression. Recruitment to this trial has been above expectation with over 90% follow-up. Results will be available soon.
Finally I will present the results of our COMMAND trial of CBT to reduce compliance with harmful, commanding voices. This trial recruited 197 individuals with commanding voices who had recently complied with serious harm to self or others. The CBT intervention reduced further compliance by nearly a half. This trial is the first to show a major reduction in risk behaviour so characteristic of young men with psychosis