@article{9e9c5b524496469bb09e89cc830648e3,
title = "SlowMo therapy, a new digital blended therapy for fear of harm from others: An account of therapy personalisation within a targeted intervention",
abstract = "Abstract: Objectives: SlowMo therapy is a pioneering blended digital therapy for paranoia, augmenting face‐to‐face therapy with an interactive {\textquoteleft}webapp{\textquoteright} 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: {\textquoteleft}Persecutory{\textquoteright} (92.9% of people) and {\textquoteleft}Negative social evaluation{\textquoteright} (74.3%) were most common. {\textquoteleft}General worries/ life stresses{\textquoteright} (31.4%) and {\textquoteleft}Negative self‐concept{\textquoteright} (22.1%) were present in a significant minority; {\textquoteleft}Health anxieties{\textquoteright} (10%) and {\textquoteleft}Sensory‐perceptual{\textquoteright} (10%) were less common. Safer thoughts: {\textquoteleft}Second‐wave (general) coping{\textquoteright} (85%), {\textquoteleft}Safer alternatives{\textquoteright} (76.4%), {\textquoteleft}Positive self‐concept{\textquoteright} (65.7%) and {\textquoteleft}Positive activities{\textquoteright} (64.3%) were common with {\textquoteleft}Third‐wave{\textquoteright} (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.",
keywords = "RESEARCH ARTICLE, RESEARCH ARTICLES, blended therapy, causal interventionism, cognitive behavioural therapy, digital, human‐centred design, paranoia, psychosis, user‐centred design",
author = "Thomas Ward and Amy Hardy and Rebecca Holm and Nicola Collett and Mar Rus‐Calafell and Catarina Sacadura and Alison McGourty and Claire Vella and Anna East and Michaela Rea and Helen Harding and Richard Emsley and Kathryn Greenwood and Daniel Freeman and David Fowler and Elizabeth Kuipers and Paul Bebbington and Philippa Garety",
note = "Funding Information: This project (15/48/21) was funded by the Efficacy and Mechanism Evaluation (EME) Programme, a Medical Research Council (MRC) and National Institute for Health Research (NIHR) partnership. Disclaimer: The views expressed in this publication are those of the author(s) and not necessarily those of the MRC, NHS, the National Institute for Health Research or the Department of Health and Social Care. The work was supported in part by the National Institute for Health Research (NIHR) Biomedical Research Centre at South London and Maudsley NHS Foundation Trust and King's College London (Garety and Emsley). Emsley is supported by an NIHR Research Professorship, (NIHR300051). Freeman is supported by an NIHR Research Professorship (NIHR-RP-2014–05–003) and the NIHR Oxford Health Biomedical Research Centre (BRC-1215–20005). Fowler is part funded by the NIHR Kent, Surrey and Sussex NIHR Applied Research Collaboration. We thank the people who have kindly given permission to share their experiences of SlowMo therapy; experiences shared in the expressed hope that others will understand that they are not alone. Funding Information: The work was supported in part by the National Institute for Health Research (NIHR) Biomedical Research Centre at South London and Maudsley NHS Foundation Trust and King's College London (Garety and Emsley). Emsley is supported by an NIHR Research Professorship, (NIHR300051). Freeman is supported by an NIHR Research Professorship (NIHR‐RP‐2014–05–003) and the NIHR Oxford Health Biomedical Research Centre (BRC‐1215–20005). Fowler is part funded by the NIHR Kent, Surrey and Sussex NIHR Applied Research Collaboration. Funding Information: This project (15/48/21) was funded by the Efficacy and Mechanism Evaluation (EME) Programme, a Medical Research Council (MRC) and National Institute for Health Research (NIHR) partnership. Publisher Copyright: {\textcopyright} 2021 The Authors. Psychology and Psychotherapy: Theory, Research and Practice published by John Wiley & Sons Ltd on behalf of The British Psychological Society.",
year = "2022",
month = jun,
doi = "10.1111/papt.12377",
language = "English",
volume = "95",
pages = "423--446",
journal = "PSYCHOLOGY AND PSYCHOTHERAPY",
issn = "1476-0835",
number = "2",
}