Facilitating hope as protection against social disability and the development of an Early Youth Engagement model in first episode psychosis services (the EYE project)

Presentation First Author: 
Kathryn Greenwood

Background Early intervention in Psychosis (EIP) is pivotal in determining its long term trajectory, yet 25-33% of people disengage within 12 months. Of those who remain engaged, a significant proportion have delayed social recovery. Method The first study investigated facilitators and barriers to engagement from the perspective of EIP service users, their relatives and healthy young people in order to develop a youth-engagement focussed service model. Forty focus groups/individual interviews were conducted, and thematic analysis was applied to the transcribed data. A delphi consultation was conducted with 27 clinicians, managers and experts, to reach consensus on the new engagement model. The second study investigated (i) the role of positive (social and occupational hope) and negative (defeatist social and performance) self-beliefs and (ii) their interaction with therapeutic relationships on social inclusion in 387 healthy young people and 51 young EIP service users. Results Therapeutic engagement with EIP services at its best includes (i) transparent, hopeful communication; (ii) socially inclusive practice; (iii) open, accessible services (iv) positive experiences with staff, and (v) engagement-oriented personal characteristics. The engagement model included myth-busting booklets and website, social involvement with family, friends, peer workers and groups and (iii) service and staff training to enhance positive goal-directed, hope-inspiring relationships. Social inclusion was influenced by both positive and negative self-beliefs, but only hope was important for younger people. Hope-inspiring therapeutic relationships facilitated social inclusion (and occupational) outcomes. Conclusion Understanding and promoting hopeful engagement from multiple perspectives is protective against disengagement and social disability in young people with psychosis.

Conference Name: 
Presentation Date: 
January, 2015
Additional Authors: 
Clio Berry - Kirsty Labuschagne - Ruth Chandler - Richard deVisser - Emmanuelle Peters - Andy Field - Philippa Garety
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