Acceptability of a novel suicide prevention psychological therapy for people who experience non‐affective psychosis

Harris, Kamelia and Gooding, Patricia A. and Awenat, Yvonne and Haddock, Gillian and Cook, Leanne and Huggett, Charlotte and Jones, Steven and Lobban, Fiona and Peeney, Ellen and Pratt, Daniel and Peters, Sarah (2023) Acceptability of a novel suicide prevention psychological therapy for people who experience non‐affective psychosis. Psychology and Psychotherapy: Theory, Research and Practice, 96 (3). pp. 560-576. ISSN 1476-0835

Abstract

AbstractObjectivesSuicide is a leading cause of death worldwide. People experiencing psychosis are at increased risk of death by suicide. Talking therapies can alleviate suicidal thoughts, plans, and attempts. Therapies need to also be acceptable to recipients. The aim of this study was to investigate the views on psychological therapy for people experiencing psychosis and suicidality using the Theoretical Framework of Acceptability.DesignQualitative interview study.MethodsParticipants were recruited from a randomised controlled trial comparing suicide prevention psychological therapy with treatment as usual. Individuals had a diagnosis of non‐affective psychosis and experience of suicidal thoughts, plans and/or attempts. To assess the acceptability of the therapy, semi‐structured interviews were conducted with 20 participants randomised to receive therapy. Data were deductively analysed using an adaptation of the Theoretical Framework of Acceptability.ResultsInterviews (Mean = 45 min) were conducted and audio recorded with 21 participants. Data were organised into six themes: 1. Affective attitude, 2. Burden, 3. Alliance, 4. Intervention coherence, 5. Perceived effectiveness, and 6. Self‐efficacy. There was no evidence of issues relating to domains of ethicality and opportunity costs associated with receiving therapy.ConclusionsTalking about suicide was difficult and, at times, distressing, but it was perceived to be useful for understanding experiences. To be acceptable, it is important for therapists to ensure that clients' understanding of therapy aligns with expectations of effectiveness and to invest in building strong therapeutic alliances. Future research will benefit from examining therapists' experiences of delivering therapy through different modes (e.g. online, telephone).