SlowMo therapy, a new digital blended therapy for fear of harm from others: An account of therapy personalisation within a targeted intervention

Thomas Ward*, Amy Hardy, Rebecca Holm, Nicola Collett, Mar Rus‐Calafell, Catarina Sacadura, Alison McGourty, Claire Vella, Anna East, Michaela Rea, Helen Harding, Richard Emsley, Kathryn Greenwood, Daniel Freeman, David Fowler, Elizabeth Kuipers, Paul Bebbington, Philippa Garety

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

2 Citations (Scopus)
95 Downloads (Pure)


Abstract: Objectives: SlowMo therapy is a pioneering blended digital therapy for paranoia, augmenting face‐to‐face therapy with an interactive ‘webapp’ and a mobile app. A recent large‐scale trial demonstrated small–moderate effects on paranoia alongside improvements in self‐esteem, worry, well‐being and quality of life. This paper provides a comprehensive account of therapy personalisation within this targeted approach. Design: Case examples illustrate therapy delivery and descriptive data are presented on personalised thought content. Method: Thought content was extracted from the webapp (n = 140 participants) and coded using newly devised categories: Worries: (1) Persecutory, (2) Negative social evaluation, (3) Negative self‐concept, (4) Loss/life stresses, (5) Sensory‐perceptual experiences and (6) Health anxieties. Safer thoughts: (1) Safer alternative (specific alternatives to worries), (2) Second‐wave (generalised) coping, (3) Positive self‐concept, (4) Positive activities and (5) Third‐wave (mindfulness‐based) coping. Data on therapy fidelity are also presented. Results: Worries: ‘Persecutory’ (92.9% of people) and ‘Negative social evaluation’ (74.3%) were most common. ‘General worries/ life stresses’ (31.4%) and ‘Negative self‐concept’ (22.1%) were present in a significant minority; ‘Health anxieties’ (10%) and ‘Sensory‐perceptual’ (10%) were less common. Safer thoughts: ‘Second‐wave (general) coping’ (85%), ‘Safer alternatives’ (76.4%), ‘Positive self‐concept’ (65.7%) and ‘Positive activities’ (64.3%) were common with ‘Third‐wave’ (mindfulness) coping observed for 30%. Fidelity: Only three therapy withdrawals were therapy related. Session adherence was excellent (mean = 15.2/16; SD = 0.9). Behavioural work was conducted with 71% of people (119/168). Conclusion: SlowMo therapy delivers a targeted yet personalised approach. Potential mechanisms of action extend beyond reasoning. Implications for cognitive models of paranoia and causal interventionist approaches are discussed.
Original languageEnglish
Pages (from-to)423-446
Number of pages24
Issue number2
Early online date12 Jan 2022
Publication statusPublished - Jun 2022


  • blended therapy
  • causal interventionism
  • cognitive behavioural therapy
  • digital
  • human‐centred design
  • paranoia
  • psychosis
  • user‐centred design


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