Telehealth Imagery Focused Therapy for People with Delusions

Cairns, Aimee and Kelly, James (2022) Telehealth Imagery Focused Therapy for People with Delusions. PhD thesis, Lancaster University.

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Abstract

This thesis explores telehealth imagery focused therapy for people with delusions. Delusions, particularly persecutory delusions, can cause distress and are linked to deterioration in psychological wellbeing. Mental imagery is a factor associated with such distress and interventions targeting this could be beneficial. Section one reports on a quantitative systematic literature review that examines the outcomes imagery focused interventions for people with psychosis and delusions. Six databases were searched (PsycINFO, PubMed, MEDLINE, Web of Science, EMBASE, CINAHL) and eight studies were found to meet the requirements for inclusion. These studies largely supported their aims in reducing levels of distress and intrusiveness of imagery. Results suggest that interventions targeting mental imagery are acceptable, feasible and safe within a population of people with psychosis. Further research that uses more robust methodological designs and larger sample sizes is needed. Section two reports on an empirical study that aimed to examine the feasibility and acceptability of a telehealth imagery-based therapeutic intervention for people experiencing persecutory delusions. A non-concurrent A-B multiple-baseline design was used. Five participants, all female, completed multiple baselines (minimum three, maximum five sessions) and six therapy sessions. There was a 100% completion rate of sessions and measures. Participants reported clinically significant improvement on at least one measure and all participants reported a reduction in delusions and the realness and compelling nature of distressing imagery. No adverse effects were found and participant feedback was positive. Limitations of the study include an all-female sample, small sample size and lack of control group. Overall, the delivery of an imagery-focused intervention via telehealth appears to be feasible and acceptable. Section three includes the critical appraisal which reflects on the process of conducting this project. It summarises prior sections, discusses key considerations of the research and considers future research.