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A novel CBT informed intervention for social anxiety in people recovering from psychosis.

A novel CBT informed intervention for social anxiety in people recovering from psychosis. Ruth Turner, Richard White, Rebecca Lower, Lina Gega, David Fowler. Acknowledgements.

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A novel CBT informed intervention for social anxiety in people recovering from psychosis.

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  1. A novel CBT informed intervention for social anxiety in people recovering from psychosis. Ruth Turner, Richard White,Rebecca Lower, Lina Gega, David Fowler

  2. Acknowledgements • Everyone who has helped to make the Social Anxiety Research Clinic successful: Tony Reilly,Timothy Clarke, Felicity Waite, Evelina Medin, Kevin Lloyd, Rose Christopher, Emily Drake all of our participants,and the case managers within Central Norfolk Early Intervention Team

  3. Social Anxiety Research Clinic • Describe participants • Brief description of intervention • Describe findings • Discussion of use of virtual environments

  4. Background • Up to 70% of people recovering from psychosis experience social anxiety. • This is a significant barrier to social recovery. • Social anxiety appears to be independent of the experience of positive symptoms

  5. Description of sample at baseline • Demographics: ; 17 male, 5 female; Average age = 26 (S.D. 6) • PANSS (data for 13 participants) average score on positive sub-scale = 10.9 (S.D. = 3.0). 46% (n = 6) of participants scored 4 or more on one or more items of the sub-scale. • BDI average score = 26.6 (S.D. 15.8) • SIAS:

  6. Description of sample at baseline SSI BCSS

  7. Formulation Based on Clarke and Wells model

  8. Intervention • The intervention is an assisted self-help intervention which follows four stages: • first stage included an assessment of social anxiety, goal setting and psycho-education about social anxiety. • Stage two helped patients develop an individualised CBT formulation. Patients identified their own idiosyncratic safety behaviours. • Stage three involved repeated exposure to anxiety provoking social situations in the format of behavioural experiments • The final stage focussed on maximising patients’ gains by planning further exposure-based behavioural experiments which were done either independently by the patient or with support from the care team. • Additional interventions were piloted using computerised cognitive bias modification and virtual environments.

  9. Outcomes - SIAS • Baseline SIAS scores were compared to those at the 12, 18 and 24 week follow up points.

  10. Outcome - SIAS

  11. Additional pilot interventions • Preliminary evidence that CBM-I sentence completion task can be used to train a more positive interpretation bias in this group. • Virtual environments are being used to provide additional situations in which behavioural experiments can be conducted.

  12. CAFÉ “sitting down waiting to order”

  13. Conclusions • Preliminary evidence that an assisted self-help intervention may help to reduce the level of social anxiety in people recovering from psychosis. • Psychoeducation about social anxiety and the active engagement in behavioural experiments seems to be key.

  14. Any questions? • Ruth.turner@nwmhp.nhs.uk

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