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Recovery After Psychosis (RAP): A Compassion Focused Programme for Individuals Residing in High Security Settings

Published online by Cambridge University Press:  21 September 2009

Heather Laithwaite ,
Martin O'Hanlon ,
Padraig Collins ,
Patrick Doyle ,
Lucy Abraham ,
Shauneen Porter  and
Andrew Gumley
Heather Laithwaite*
Affiliation:
The State Hospital, Carstairs, Scotland
Martin O'Hanlon
Affiliation:
The State Hospital, Carstairs, Scotland
Padraig Collins
Affiliation:
The State Hospital, Carstairs, Scotland
Patrick Doyle
Affiliation:
The State Hospital, Carstairs, Scotland
Lucy Abraham
Affiliation:
The State Hospital, Carstairs, Scotland
Shauneen Porter
Affiliation:
The State Hospital, Carstairs, Scotland
Andrew Gumley
Affiliation:
University of Glasgow, Scotland
*
Reprint requests to Heather Laithwaite, Rowanbank Clinic, Balornock, Glasgow G21 3UL, Scotland. E-mail: [email protected]
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Abstract

Background: The aim of the study was to evaluate the effectiveness of a recovery group intervention based on compassionate mind training, for individuals with psychosis. In particular, the objective was to improve depression, to develop compassion towards self, and to promote help seeking. Method: A within-subjects design was used. Participants were assessed at the start of group, mid-group (5 weeks), the end of the programme and at 6 week follow-up. Three group programmes were run over the course of a year. Nineteen participants commenced the intervention and 18 completed the programme. Results: Significant improvements were found on the Social Comparison Scale; the Beck Depression Inventory; Other As Shamer Scale; the Rosenberg Self-Esteem Inventory and the General Psychopathology Scale from the Positive and Negative Syndrome Scale. Conclusions: The results provide initial indications of the effectiveness of a group intervention based on the principles of compassionate focused therapy for this population. The findings of this study, alongside implications of further research are discussed.

Keywords

Psychosiscompassionate mind trainingrecoveryoffenders
Type
Research Article
Information
Behavioural and Cognitive Psychotherapy , Volume 37 , Issue 5 , October 2009 , pp. 511 - 526
Copyright
Copyright © British Association for Behavioural and Cognitive Psychotherapies 2009

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References

Allan, S. and Gilbert, P. (1995). A social comparison scale: psychometric properties and relationships to psychopathology. Personality and Individual Differences, 1, 293–299CrossRefGoogle Scholar
Allan, S., Gilbert, P. and Goss, K. (1994). An exploration of shame measures: II. Psychopathology. Personality and Individual Differences, 17, 719–722.CrossRefGoogle Scholar
Baumeister, R. F., Smart, L. and Boden, J. M. (1997). Relation to threatened egotism to violence and aggression: the dark side of high self-esteem. Psychological Review, 103, 5–33.CrossRefGoogle Scholar
Bebbington, P. E., Bhugra, D., Brugha, T., Singleston, N., Farrell, M., Jenkins, G., Lewis, G and Meltzer, H (2004). Psychosis, victimization and childhood disadvantage: evidence from the second British National Survey of psychiatric morbidity. British Journal of Psychiatry, 185, 220–226.CrossRefGoogle ScholarPubMed
Beck, A. T., Steer, R. A. and Brown, G. K. (1996). Manual for the Beck Depression Inventory –II. San Antonio TX, The Psychological Corporation.Google Scholar
Bentall, R. P., Kinderman, P. and Kaney, S. (1994). The self, attributional processes and abnormal beliefs: towards a model of persecutory delusions. Behaviour Research and Therapy, 32, 331–341.CrossRefGoogle Scholar
Birchwood, M. J., Hallett, S. E. and Preston, M. C. (1989). Schizophrenia: an integrated approach to research and treatment. New York: New York University Press.Google Scholar
Birchwood, M., Mason, R., MacMillan, F. and Healy, J. (1993). Depression, demoralisation and control over psychotic illness: a comparison of depressed and non-depressed patients with a chronic psychosis. Psychological Medicine, 23, 387–395.CrossRefGoogle ScholarPubMed
Birchwood, M. and Iqbal, Z. (1998). Depression and suicidal thinking in psychosis: a cognitive approach. In Wykes, T., Tarrier, N. and Lewis, S. (Eds.), Outcome and Innovation in Psychological Treatment of Schizophrenia (pp. 81–100). Hoboken, NJ: John Wiley and Sons Inc.Google Scholar
Boswell, G. (1996). Young and Dangerous: the backgrounds and careers of section 53 offenders. Aldershot: Avebury.Google Scholar
Bowlby, J. (1988). A Secure Base: clinical applications of attachment theory. London: Routledge.Google Scholar
Buss, D. M. (2003). Evolutionary Psychology: the new sciences of mind (2nd edn). Boston: Allyn and Bacon.Google Scholar
Butler, R. J. and Gasson, S. L (2004). The Self-Image Profile for Adults (SIP-Adult). San Antonio, TX: Harcourt Assessment.Google Scholar
Campbell, M. L. C. and Morrison, A. P. (2007). The relationship between bullying, psychotic-like experiences and appraisals in 14–16 year olds. Behaviour Research and Therapy, 45, 1579–1591.CrossRefGoogle Scholar
Day, A., Gerace, A., Wilson, C. and Howells, K. (2008). Promoting forgiveness in violent offenders: a more positive approach to offender rehabilitation? Aggression and Violent Behaviour, 13, 195–200.CrossRefGoogle Scholar
Fonagy, P., Target, M., Steele, M., Steele, H., Leigh, T., Levinson, A. and Kennedy, R. (1997). Morality, disruptive behaviour, borderline personality disorder, crime, and their relationships to security of attachment. In Atkinson, L. and Zucker, K. J. (Eds.), Attachment and Psychopathology. New York: Guilford Press.Google Scholar
Fonagy, P., Gergely, G., Jurist, E. L. and Target, M. (2002). Affect Regulation, Mentalisation, and the Development of the Self. London: Karnac.Google Scholar
Garety, P. A., Kuipers, E., Fowler, D., Freeman, D. and Bebbington, P. E. (2001). A cognitive model of the positive symptoms of psychosis. Psychological Medicine, 31, 189–195.CrossRefGoogle ScholarPubMed
Gilbert, P. (1989). Human Nature and Suffering. Hove: Lawrence Erlbaum.Google Scholar
Gilbert, P. (1992). Depression: the evolution of powerlessness. Hove: Lawrence Erlbaum.Google Scholar
Gilbert, P. (2000). Social mentalities: internal “social” conflicts and the role of inner warmth and compassion in cognitive therapy. In Gilbert, P. and Bailey, K. G. (Eds.), Genes on the Couch; explorations in evolutionary psychotherapy (pp. 118–150). Hove: Psychology Press.Google Scholar
Gilbert, P. (2001). Evolutionary approaches to psychopathology: the role of natural defences. Australian and New Zealand Journal of Psychiatry, 35, 17–27.CrossRefGoogle ScholarPubMed
Gilbert, P. (2003). Evolution, social roles and the differences in shame and guilt. Social Research, 70, 401–426.CrossRefGoogle Scholar
Gilbert, P. (2004). Depression: a biopsychosocial, integrative and evolutionary approach. In Power, M. (Ed.), Mood Disorders: a handbook of science and practice (pp. 99–142). Chichester: Wiley.CrossRefGoogle Scholar
Gilbert, P. (2005). Compassion and cruelty: a biopsychosocial approach. In Gilbert, P. (Ed.), Compassion: conceptualisations, research and use in psychotherapy (pp. 9–74). Brighton: Brunner-Routledge.CrossRefGoogle Scholar
Gilbert, P., Cheung, M. S-P., Grandfield, T., Campey, F. and Irons, C. (2003). Recall of threat and submissiveness in childhood: development of a new scale and its relationship with depression, social comparison and shame. Clinical Psychology and Psychotherapy, 10, 108–115.CrossRefGoogle Scholar
Gilbert, P. and Irons, C. (2005). Focused therapies and compassionate mind training for shame and self-attacking. In Gilbert, P. (Ed.), Compassion: conceptualisations, research and use in psychotherapy (pp. 263–326). London: Routledge.CrossRefGoogle Scholar
Gilbert, P. and Miles, J. N. V. (2000). Sensitivity to social put down: its relationship to perceptions of social rank, shame, social anxiety, depression, anger and self-other blame. Personality and Individual Differences, 29, 757–774.CrossRefGoogle Scholar
Gilbert, P. and Proctor, S. (2006). Compassionate mind training for people with high shame and self-criticism: overview and pilot study of a group approach. Clinical Psychology and Psychotherapy, 13, 353–379.CrossRefGoogle Scholar
Goss, K., Gilbert, P. and Allan, S. (1994). An exploration of shame measures I. the “other as shamer scale”. Personality and Individual Differences, 17, 713–717.CrossRefGoogle Scholar
Gumley, A. and Schwannauer, M,(2006). Staying Well After Psychosis: a cognitive interpersonal approach to recovery and relapse prevention. New York: Wiley.Google Scholar
Haddock, G., Lowens, I., Brosnan, N., Barrowclough, C. and Novaco, R. W. (2004). Cognitive-behavioural therapy for in-patients with psychosis and anger problems within a low secure environment. Behavioural and Cognitive Psychotherapy, 32, 77–98.CrossRefGoogle Scholar
Herz, M. I. and Melville, C. (1980). Relapse in schizophrenia. American Journal of Psychiatry, 137, 801–805.Google ScholarPubMed
Kay, S., Fiszbein, A. and Opler, I. (1987). The positive and negative syndrome scale (PANSS) for schizophrenia. Schizophrenia Bulletin, 13, 261–275.CrossRefGoogle ScholarPubMed
Laithwaite, H. and Gumley, A. (2007). Sense of self, adaptation and recovery in patients with psychosis in a forensic NHS setting. Clinical Psychology and Psychotherapy, 14, 302–316.CrossRefGoogle Scholar
Laithwaite, H., Gumley, A., Benn, A., Scott, E., Downey, K., Black, K. and McEwen, S. (2007). Self-esteem and psychosis: a pilot study investigating the effectiveness of a self-esteem programme on the self-esteem and positive symptomatology of mentally disordered offenders. Behavioural and Cognitive Psychotherapy, 35, 569–577.CrossRefGoogle Scholar
Liotti, G. and Gumley, A. (2008). An attachment perspective on schizophrenia: the role of disorganised attachment, dissociation and mentalisation. Psychosis, Trauma and Dissociation, 14, 117–133.CrossRefGoogle Scholar
Lee, D. (2005). The perfect nurturer: a model to develop a compassionate mind within the context of cognitive therapy. In Gilbert, P. (Ed.), Compassion: conceptualisations, research and use in psychotherapy. London: Bruner-Routledge.Google Scholar
Legg, L. and Gilbert, P. (2006). A pilot study of gender of voice and gender of voice hearer in psychotic voice hearers. Psychology and Psychotherapy: Theory, Research and Practice, 79, 517–527.CrossRefGoogle ScholarPubMed
MacBeth, A., Schwannauer, M. and Gumley, A. (2008). The association between attachment style, social mentalities, and paranoid ideation: an analogue study. Psychology and Psychotherapy: Theory, Research and Practice, 81, 79–93.CrossRefGoogle ScholarPubMed
McCandless-Glimcher, L., McKnight, S., Hamera, E., Smith, B. L., Peterson, K. A. and Plumlee, A. A. (1986). Use of symptoms by schizophrenics to monitor and regulate their illness. Hospital and Community Psychiatry. 37, 929–933.Google ScholarPubMed
Murphy, J. M., Nierenberg, A. A., Monson, R. R., Laird, N. M., Sobol, A. M. and Leighton, A. H. (2002). Self-disparagement as a feature and forerunner of depression: findings from the Stirling County study. Comprehensive Psychiatry, 43, 13–21.CrossRefGoogle ScholarPubMed
Neff, K. D. (2003a). Self-compassion: an alternative conceptualisation of a healthy attitude towards oneself. Self and Identity, 2, 85–102CrossRefGoogle Scholar
Neff, K. D. (2003b). The development and validation of a scale to measure self-compassion. Self and Identity, 2, 223–250.CrossRefGoogle Scholar
Read, J., Goodman, L., Morrison, A., Ross, C., and Aderhold, V. (2004). Childhood trauma, loss and stress. In Read, J., Mosher, L. and Bentall, R. (Eds.), Models of Madness: psychological, social and biological approaches to schizophrenia (pp. 223–252). Hove, Brunner-Routledge.CrossRefGoogle Scholar
Read, J. and Gumley, A. (2008). Can attachment theory help explain the relationship between childhood adversity and psychosis? Attachment: New Directions in Psychotherapy and Relational Psychoanalysis, 2, 1–35Google Scholar
Romme, M. A. J. and Escher, A. D. M. A. C. (1989). Hearing voices. Schizophrenia Bulletin, 15, 209–216.CrossRefGoogle ScholarPubMed
Rooke, O. and Birchwood, M. (1998). Loss, humiliation and entrapment as appraisals of schizophrenic illness: a prospective study of depressed and non-depressed patients. British Journal of Clinical Psychology, 37, 259–268.CrossRefGoogle Scholar
Rosenberg, M. (1965). Society and Adolescent Self-Image. Princeton, NJ: Princeton University Press.CrossRefGoogle Scholar
Rosenberg, M., Schooler, C., Schoenbach, C. and Rosenberg, F. (1995). Global self-esteem and specific self-esteem: different concepts, different outcomes. American Sociological Review, 60, 141–156.CrossRefGoogle Scholar
Sloman, L. (2000). How involuntary defeat is related to depression. In Sloman, L. and Gilbert, P. (Eds.), Subordination and Defeat: an evolutionary approach to mood disorders and their therapy (pp. 47–66). Mahwah, NJ: Lawrence Erlbaum.CrossRefGoogle Scholar
Sloman, L., Gilbert, P. and Hasey, G. (2003). Evolved mechanisms in depression: the role and interaction of attachment and social rank in depression. Journal of Affective Disorders, 74, 107–121.CrossRefGoogle ScholarPubMed
Smith, B., Fowler, D. G., Freeman, D., Bebbington, P., Bashforth, H., Garety, P., Dunn, G. and Kuipers, E. (2006). Emotion and psychosis: links between depression, self-esteem, negative schematic beliefs and delusions and hallucinations. Schizophrenia Research, 86, 181–188.CrossRefGoogle ScholarPubMed
The State Hospitals Board for Scotland (2005). The State Hospital Annual Review. Carstairs: Author.Google Scholar
Ward, T. and Marshall, W. L. (2004). Good lives, aetiology and the rehabilitation of sex offenders: a bridging theory. Journal of Sexual Aggression, 10, 153–169.CrossRefGoogle Scholar
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