title: Psychological interventions for housebound people with psychosis: service user and therapist perspectives in South East London.
abstract: BACKGROUND
  People with psychosis often have difficulty leaving their homes to perform tasks of daily living, which also limits their access to clinic-based interventions to support recovery. Home-based psychological therapy may offer a solution.
  
  
  OBJECTIVE
  To examine service user and therapist perspectives on (i) houseboundness in psychosis and (ii) the value of home-based psychological interventions, as a first step towards a systematic evaluation.
  
  
  METHODS
  Semistructured interviews with 10 service users and 12 therapists from a large inner city mental health NHS Foundation Trust were thematically analysed.
  
  
  RESULTS
  Houseboundness most commonly resulted from anxiety, paranoia and amotivation, indicating the potential usefulness of targeted psychological therapies. Home-based therapy was offered unsystematically, with variable goals. Although beneficial for engagement and assessment, little gain was reported from undertaking a full course of therapy at home.
  
  
  CONCLUSIONS
  Home visits could be offered by psychological therapists to engage and assess housebound service users, but home-based therapy may be best offered on a short-term basis, targeting paranoia, anxiety and amotivation to increase access to other resources. Given the increased cost associated with home-based psychological interventions, a systematic evaluation of their impact is warranted.
authors.affiliation: a Department of Psychology , King's College London, Institute of Psychiatry, Psychology and Neuroscience , London , UK .|b South London and Maudsley NHS Foundation Trust , London , UK , and.
authors.forename: Catherine
authors.initials: C
authors.lastname: Iredale
authors.affiliation: a Department of Psychology , King's College London, Institute of Psychiatry, Psychology and Neuroscience , London , UK .|b South London and Maudsley NHS Foundation Trust , London , UK , and.|c Department of Clinical , Educational and Health Psychology, University College London , London , UK.
authors.forename: Miriam
authors.initials: M
authors.lastname: Fornells-Ambrojo
authors.affiliation: a Department of Psychology , King's College London, Institute of Psychiatry, Psychology and Neuroscience , London , UK .
authors.forename: Suzanne
authors.initials: S
authors.lastname: Jolley
mesh_terms: D000328:Adult; D001291:Attitude of Health Personnel; D005260:Female; D006699:Home Care Services / Q000592:standards*; D006792:House Calls; D006801:Humans; D008297:Male; D008605:Mental Health Services / Q000592:standards*; D008875:Middle Aged; D020380:Needs Assessment; D011618:Psychotic Disorders / Q000523:psychology* / Q000628:therapy*
keywords: Schizophrenia; access; community mental health; engagement; low-intensity