Trauma-focused therapy in early psychosis: results of a feasibility randomized controlled trial of EMDR for psychosis (EMDRp) in early intervention settings.


Varese, Filippo, Sellwood, William, Pulford, Daniel, Awenat, Yvonne, Bird, Leanne, Bhutani, Gita ORCID: 0000-0002-2732-6479, Carter, Lesley-Anne, Davies, Linda, Aseem, Saadia, Davis, Claire et al (show 10 more authors) (2023) Trauma-focused therapy in early psychosis: results of a feasibility randomized controlled trial of EMDR for psychosis (EMDRp) in early intervention settings. Psychological medicine, 54 (5). pp. 874-885.

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Abstract

<h4>Background</h4>Trauma is prevalent amongst early psychosis patients and associated with adverse outcomes. Past trials of trauma-focused therapy have focused on chronic patients with psychosis/schizophrenia and comorbid Post-Traumatic Stress Disorder (PTSD). We aimed to determine the feasibility of a large-scale randomized controlled trial (RCT) of an Eye Movement Desensitization and Reprocessing for psychosis (EMDRp) intervention for early psychosis service users.<h4>Methods</h4>A single-blind RCT comparing 16 sessions of EMDRp + TAU <i>v.</i> TAU only was conducted. Participants completed baseline, 6-month and 12-month post-randomization assessments. EMDRp and trial assessments were delivered both in-person and remotely due to COVID-19 restrictions. Feasibility outcomes were recruitment and retention, therapy attendance/engagement, adherence to EMDRp treatment protocol, and the 'promise of efficacy' of EMDRp on relevant clinical outcomes.<h4>Results</h4>Sixty participants (100% of the recruitment target) received TAU or EMDR + TAU. 83% completed at least one follow-up assessment, with 74% at 6-month and 70% at 12-month. 74% of EMDRp + TAU participants received at least eight therapy sessions and 97% rated therapy sessions demonstrated good treatment fidelity. At 6-month, there were signals of promise of efficacy of EMDRp + TAU <i>v.</i> TAU for total psychotic symptoms (PANSS), subjective recovery from psychosis, PTSD symptoms, depression, anxiety, and general health status. Signals of efficacy at 12-month were less pronounced but remained robust for PTSD symptoms and general health status.<h4>Conclusions</h4>The trial feasibility criteria were fully met, and EMDRp was associated with promising signals of efficacy on a range of valuable clinical outcomes. A larger-scale, multi-center trial of EMDRp is feasible and warranted.

Item Type: Article
Uncontrolled Keywords: Humans, Treatment Outcome, Feasibility Studies, Stress Disorders, Post-Traumatic, Psychotic Disorders, Schizophrenia, Eye Movement Desensitization Reprocessing
Divisions: Faculty of Health and Life Sciences
Faculty of Health and Life Sciences > Institute of Population Health
Depositing User: Symplectic Admin
Date Deposited: 20 Mar 2024 09:31
Last Modified: 20 Mar 2024 09:32
DOI: 10.1017/s0033291723002532
Open Access URL: https://www.cambridge.org/core/journals/psychologi...
Related URLs:
URI: https://livrepository.liverpool.ac.uk/id/eprint/3179724
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