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Title: Targeting reasoning biases in delusions : a pilot study of the 'Thinking Well Group'
Author: Jones, Alison
Awarding Body: King's College London (University of London)
Current Institution: King's College London (University of London)
Date of Award: 2014
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Delusions often persist despite antipsychotic medication and Cognitive Behavioural Therapy and can significantly affect quality of life. ‘Jumping to conclusions’ and ‘belief flexibility’ are reasoning biases implicated in the formation and maintenance of delusions. A computerised cognitive-behavioural treatment package targeting these biases has shown promise in improving jumping to conclusions, belief flexibility and conviction. The present study is the first to adapt and pilot the reasoning intervention in a group format. It was anticipated that a group format could be more cost effective and have additional benefits of group therapeutic processes. The primary aim of the study was to assess the acceptably and feasibility of the intervention in a group format. The secondary aim, although not powered to detect significant effects, was to explore the impact of the group on conviction, jumping to conclusions, belief flexibility and paranoia, as well as on affect, activity levels and schemas. Twenty-one participants with a diagnosis of Schizophrenia-spectrum Disorder and at least 50% conviction in a distressing delusion were recruited. Participants were randomised in a 2:1 ratio to either the group or a waitlist control. Three groups were run over a six month period. The group intervention involved six weekly 1.5 hour sessions, comprising group discussion and exercises to support the learning of CBT-based techniques aiming to improve jumping to conclusions and belief flexibility. Outcomes were assessed at pre-group, post-group and at one month follow-up. Semi-structured interviews to collect qualitative feedback on the intervention were also completed. Results showed the group format was feasible and acceptable, had high attendance rates and participant satisfaction. Thematic analysis of qualitative feedback indicated the majority of participants highlighted positive changes in jumping to conclusions, belief flexibility and improvement in functioning, as well as benefits from group therapeutic processes. Analyses between pre and post-group revealed a statistical trend towards a decrease in delusional conviction and significant improvements in jumping to conclusions and belief flexibility in those who attended the group in comparison to the control group. Secondary outcome measures between pre and post-group also found significant improvements in activity levels, self-schemas and affect, with some improvements maintained at follow-up. A larger trial sufficiently powered to detect change is required to further assess the effectiveness of the intervention.
Supervisor: Waller, Helen; Hardy, Amy Sponsor: Not available
Qualification Name: Thesis (D.Clin.Psy.) Qualification Level: Doctoral
EThOS ID:  DOI: Not available