SlowMo therapy, a new digital blended therapy for fear of harm from others: An account of therapy personalisation within a targeted intervention. (12th January 2022)

• Record Type: Journal Article
• Authors: Ward, Thomas; Hardy, Amy; Holm, Rebecca; Collett, Nicola; Rus‐Calafell, Mar; Sacadura, Catarina; McGourty, Alison; Vella, Claire; East, Anna; Rea, Michaela; Harding, Helen; Emsley, Richard; Greenwood, Kathryn; Freeman, Daniel; Fowler, David; Kuipers, Elizabeth; Bebbington, Paul; Garety, Philippa
• Is Part Of: Psychology and psychotherapy. Volume 95:Part 2(2022)
• Page Start: 423
• Page End: 446
• Publication Date: 2022-01-12
• Subjects: blended therapy -- causal interventionism -- cognitive behavioural therapy -- digital -- human‐centred design -- paranoia -- psychosis -- user‐centred design; Clinical psychology -- Periodicals; Psychotherapy -- Periodicals; Mental illness -- Psychological aspects -- Periodicals; 616.89
• DOI: 10.1111/papt.12377
• Languages: English
• ISSNs: 1476-0835

Abstract

Abstract: Objectives: SlowMo therapy is a pioneering blended digital therapy for paranoia, augmenting face‐to‐face therapy with an interactive 'webapp' and a mobile app. A recent large‐scale trial demonstrated small–moderate effects on paranoia alongside improvements in self‐esteem, worry, well‐being and quality of life. This paper provides a comprehensive account of therapy personalisation within this targeted approach. Design: Case examples illustrate therapy delivery and descriptive data are presented on personalised thought content. Method: Thought content was extracted from the webapp ( n = 140 participants) and coded using newly devised categories: Worries: (1) Persecutory, (2) Negative social evaluation, (3) Negative self‐concept, (4) Loss/life stresses, (5) Sensory‐perceptual experiences and (6) Health anxieties. Safer thoughts: (1) Safer alternative (specific alternatives to worries), (2) Second‐wave (generalised) coping, (3) Positive self‐concept, (4) Positive activities and (5) Third‐wave (mindfulness‐based) coping. Data on therapy fidelity are also presented. Results: Worries: 'Persecutory' (92.9% of people) and 'Negative social evaluation' (74.3%) were most common. 'General worries/ life stresses' (31.4%) and 'Negative self‐concept' (22.1%) were present in a significant minority; 'Health anxieties' (10%) and 'Sensory‐perceptual' (10%) were less common. Safer thoughts: 'Second‐wave (general) coping' (85%), 'Safer alternatives' (76.4%), 'Positive self‐concept' (65.7%) and 'Positive activities' (64.3%) were common with 'Third‐wave' (mindfulness) coping observed for 30%. Fidelity: Only three therapy withdrawals were therapy related. Session adherence was excellent (mean = 15.2/16; SD = 0.9). Behavioural work was conducted with 71% of people (119/168). Conclusion: SlowMo therapy delivers a targeted yet personalised approach. Potential mechanisms of action extend beyond reasoning. Implications for cognitive models of paranoia and causal interventionist approaches are discussed.