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Title: Evaluating the feasibility of a two-session intervention targeting inflated responsibility beliefs in people who experience command hallucinations
Author: Michalczuk, Rosanna
ISNI:       0000 0004 8499 6262
Awarding Body: Royal Holloway, University of London
Current Institution: Royal Holloway, University of London
Date of Award: 2017
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Though an inflated sense of responsibility was initially considered a unique feature of OCD, recent research has identified a potentially transdiagnostic role for responsibility beliefs (RBs) in psychopathology. Studies have found people experiencing command hallucinations to endorse significantly more problematic beliefs about responsibility than either those experiencing non-commanding voices or OCD, and non-clinical controls. As such, it is suggested that novel psychological interventions for voice hearers might benefit from addressing RBs by employing similar techniques to those used in CBT for OCD. This study evaluates the feasibility and acceptability of a two-session intervention targeting RBs in people who hear command hallucinations. The research questions were: i) is recruitment and retention of participants feasible; ii) are the outcomes measures utilised effective in capturing impact; iii) is the intervention as a whole acceptable to, and suitable in, this client group; iv) is the implementation of this study and intervention feasible with respect to resources; and v) do preliminary participant responses indicate the intervention to be clinically helpful. This study had three components: Phase 1 consisted of development of the intervention; Phase 2 used a Single Case Experimental Design (SCED) for preliminary evaluation of intervention effectiveness across three participants; and Phase 3 comprised Thematic Analysis (TA) of a focus group with the four participating therapists. Results show that no firm conclusions could be drawn from the SCED analysis of clinical effectiveness on measures of RBs, voice hearing and general well-being, partly due to small improvements seen in central tendency and trend across baseline. Equally, evidence suggestive of clinically significant change (CSC) is very limited. However, findings do indicate that the intervention appears safe, with no worsening of symptoms across measures. Results from Phase 3 identify six overarching themes, and broadly conclude that, in its current format, the intervention is neither feasible nor acceptable. Overall, this research demonstrates the necessity for substantial adaptations to the intervention and implementation protocol for a future feasibility study in the area. Moreover, further research is clearly required in clarifying the precise role of elevated perceived responsibility in command hallucinations. The implications of these findings and suggestions for future research are discussed.
Supervisor: Not available Sponsor: Not available
Qualification Name: Thesis (D.Clin.Psy.) Qualification Level: Doctoral
EThOS ID:  DOI: Not available