A new clinical trial from King's College London's Institute of Psychiatry, Psychology, & Neuroscience, in collaboration with Oxford University, Oxford Health NHS Foundation Trust, Sussex University, and Sussex Partnership NHS Foundation Trust has established an innovative therapy as an effective means of treating paranoid thoughts in people experiencing psychosis.
In research published in JAMA Psychiatry today, participants of the SlowMo therapy trial had eight face-to-face therapy sessions with support from an interactive web platform and app. The app, designed in collaboration with people experiencing psychosis and the Royal College of Art, is used outside the clinic to help individuals feel safer in daily life.
Paranoia is fuelled by "fast thinking"; a thinking style that is driven by instinct and gut feelings. Slowing down can help. SlowMo starts by supporting people to notice their fast thoughts, visualised as grey, fast-spinning bubbles. People learn to slow down for a moment using tips and personalised safer thoughts.
Professor Philippa Garety, Lead Researcher at SlowMo from King's IoPPN said, "In this trial, we have demonstrated that helping people to slow down their thinking, which is a simple idea, but very difficult to achieve unaided, reduces paranoia in everyday life, and improves quality of life and wellbeing. This has been made possible by devising a brief therapy which uses a powerful combination of therapy sessions and a personalised app. It is at least as effective as longer, more complex psychological treatments for paranoia, which are generally more challenging to deliver and frequently not available in clinical services. The results of this trial have been hugely exciting, and they point a way forwards to harnessing digital technology in the service of developing more effective treatments in the future."
362 people from three NHS Foundation Trusts took part in the trial, with half being provided with SlowMo therapy and their usual care, while the other half continued to receive their usual care. Over the course of six months, patients were measured on a number of outcomes, including their ability to slow down thinking. At the end of the trial, the group who had received SlowMo showed reduced levels of paranoia and worry, no longer meeting the threshold for persecutory beliefs and reported significant improvements to their wellbeing and quality of life.
Sam, who lives with psychosis and took part in the study said, "The focus on fast and slow thinking really helped. The eye catching, helpful bubbles taught me that I can end the cycle of worry, and I do not need to think speedily and start panicking. I have got that now for life. Now all my worries are lessened by SlowMo and I have freedom and peace that I did not have before." The trial was made possible with funding from the National Institute for Health Research and the Medical Research Council (Efficacy and Mechanism Evaluation). The team now have funding to develop SlowMo so that it can be tested in routine NHS services.
Dr Amy Hardy, Digital Lead at SlowMo from King's IoPPN said "It can be difficult for people to make use of traditional therapies, and we are delighted that the trial showed the SlowMo design overcame common barriers to engagement and effectiveness. It had high rates of use and satisfaction, and worked equally well for a wide range of people. We are now working on developing SlowMo so that this accessible therapy will be widely available in the NHS".
"The effects on paranoia of SlowMo, a blended digital therapy targeting reasoning for people with 2 psychosis: a randomised controlled trial" Philippa Garety PhD, Thomas Ward PhD, Richard Emsley PhD, Kathryn Greenwood PhD, Daniel Freeman PhD, David Fowler MSc, Elizabeth Kuipers PhD, Paul Bebbington PhD, Mar Rus-Calafell PhD, Alison McGourty DPsych, Catarina Sacadura PsyD, Nicola Collett DClinPsy, Kirsty James MSc, Amy Hardy PhD) is published in JAMA Psychiatry. For further information on SlowMo http://slowmotherapy.co.uk/