Background:

People who have episodes of worrying, distressing or unusual experiences or beliefs (often called ‘psychosis’) often recover from the worst of these experiences. However, people with these experiences may still have problems with their social lives and activities.  Young people in the general population tend to spend about 64 hours a week in structured activity, whereas many young people with psychosis spend less than half this amount of time in the same kinds of activities per week. Employment may be one type of structured activity, but other things like voluntary work, education, spending time with friends, leisure activities, and caring for other people are all important.

Until recently, it has been thought that it is hard to help people who have experienced psychosis and are struggling with their social lives. However, research looking at Early Intervention in Psychosis services (EIP) have found that young people with psychosis can be helped to take part in more activities. It has also been found that people who particularly struggle to take part in activities may have more problems with depression, symptoms of psychosis, and be more sensitive to social stress. Therefore, it is important to look for new and improved ways of helping young people with psychosis cope with these problems and improve their social lives and activities.

The SuperEDEN 3 study is investigating Social Recovery oriented Cognitive Behaviour Therapy (SRCBT).  The aims of SRCBT are: to carefully identify activities and occupations which are meaningful for the person; to understand any barriers people may have to undertaking the activity the person wants to do; and to help people prepare for work or leisure activities by practicing in safe and low stress environments.  The study aims to see if working with an SRCBT therapist helps to improve social recovery and to reduce symptoms of hopelessness and anxiety if present.

Methods:

The main outcome of this study is the amount of structured activity that people take part in per week. People who tend to take part in less than 30 hours of structured activity a week are being invited to take part in the research. SRCBT is a relatively new treatment.  We still do not know how exactly it helps people to improve.  The main aim of SRCBT is to try and help these people increase the amount of time they spend in structured activity. Other aims include trying to work out how SRCBT helps people with their activities- is it because SRCBT reduces depression and anxiety? Or because SRCBT helps people to feel more hopeful and positive about other people? Also, we will work out whether SRCBT is cost-effective compared to usual treatment.

This is a randomised trial, which means we do not know which treatment works best. Therefore, people will be divided into two groups, one group will receive the SRCBT and the other group will continue to receive their treatment as usual. The groups will be selected by a computer which has no information about the individual i.e. by chance. Participants will have a 50/50 chance of receiving SRCBT or treatment as usual. SRCBT can then be compared to the usual treatment that people receive.

Participants see a researcher to complete questionnaires about their activities, symptoms, thoughts and feelings, and general health. Then they will be allocated to the SRCBT or treatment as usual group. Participants will then receive the selected treatment for 9 months before seeing the researcher to fill out the same questionnaires again. Six months later, each participant will be asked to fill out the questionnaires for one final time.

Results: The results of the study will be written up for publication in health professional journals and will be presented at conferences in the UK and abroad. Results will include seeing whether SRCBT works, whether it seems better than treatment as usual, whether any benefits seem to last over time, whether SRCBT is cost-effective, and how SRCBT seems to work.