Randomised controlled trial of a digitally assisted low intensity intervention to promote personal recovery in persisting psychosis: SMART-Therapy study protocol.
Psychosocial interventions have an important role in promoting recovery in people with persisting psychotic disorders such as schizophrenia. Readily available, digital technology provides a means of developing therapeutic resources for use together by practitioners and mental health service users. As part of the Self-Management and Recovery Technology (SMART) research program, we have developed an online resource providing materials on illness self-management and personal recovery based on the Connectedness-Hope-Identity-Meaning-Empowerment (CHIME) framework. Content is communicated using videos featuring persons with lived experience of psychosis discussing how they have navigated issues in their own recovery. This was developed to be suitable for use on a tablet computer during sessions with a mental health worker to promote discussion about recovery.



This is a rater-blinded randomised controlled trial comparing a low intensity recovery intervention of eight one-to-one face-to-face sessions with a mental health worker using the SMART website alongside routine care, versus an eight-session comparison condition, befriending. The recruitment target is 148 participants with a schizophrenia-related disorder or mood disorder with a history of psychosis, recruited from mental health services in Victoria, Australia. Following baseline assessment, participants are randomised to intervention, and complete follow up assessments at 3, 6 and 9 months post-baseline. The primary outcome is personal recovery measured using the Process of Recovery Questionnaire (QPR). Secondary outcomes include positive and negative symptoms assessed with the Positive and Negative Syndrome Scale, subjective experiences of psychosis, emotional symptoms, quality of life and resource use. Mechanisms of change via effects on self-stigma and self-efficacy will be examined.



This protocol describes a novel intervention which tests new therapeutic methods including in-session tablet computer use and video-based peer modelling. It also informs a possible low intensity intervention model potentially viable for delivery across the mental health workforce.



NCT02474524 , 24 May 2015, retrospectively registered during the recruitment phase.
Centre for Mental Health, Swinburne University of Technology, PO Box 218, Hawthorn, VIC, 3122, Australia. neilthomas@swin.edu.au.|Monash Alfred Psychiatry Research Centre, Monash University and The Alfred, Melbourne, VIC, 3004, Australia. neilthomas@swin.edu.au.
Neil
0000-0001-7006-6361
N
Thomas
Department of Psychology and Counselling, La Trobe University, Melbourne, VIC, 3086, Australia.|NorthWestern Mental Health, Royal Melbourne Hospital, Melbourne, VIC, 3050, Australia.
John
J
Farhall
Centre for Mental Health, Swinburne University of Technology, PO Box 218, Hawthorn, VIC, 3122, Australia.
Fiona
F
Foley
Centre for Mental Health, Swinburne University of Technology, PO Box 218, Hawthorn, VIC, 3122, Australia.|Monash Alfred Psychiatry Research Centre, Monash University and The Alfred, Melbourne, VIC, 3004, Australia.|Department of Psychiatry, St Vincent's Hospital, Fitzroy, VIC, 3065, Australia.
Susan L
SL
Rossell
Department of Psychiatry, St Vincent's Hospital, Fitzroy, VIC, 3065, Australia.|Department of Psychiatry, University of Melbourne, Parkville, VIC, 3052, Australia.
David
D
Castle
Wellways Australia, Fairfield, VIC, 3068, Australia.
Emma
E
Ladd
Centre for Mental Health, Swinburne University of Technology, PO Box 218, Hawthorn, VIC, 3122, Australia.
Denny
D
Meyer
Centre for Population Health Research, Deakin University, Burwood, VIC, 3125, Australia.
Cathrine
C
Mihalopoulos
Centre for Mental Health, Swinburne University of Technology, PO Box 218, Hawthorn, VIC, 3122, Australia.
Nuwan
N
Leitan
Wellways Australia, Fairfield, VIC, 3068, Australia.
Cassy
C
Nunan
Wellways Australia, Fairfield, VIC, 3068, Australia.
Rosalie
R
Frankish
Wellways Australia, Fairfield, VIC, 3068, Australia.
Tara
T
Smark
Wellways Australia, Fairfield, VIC, 3068, Australia.
Sue
S
Farnan
Centre for Mental Health, Swinburne University of Technology, PO Box 218, Hawthorn, VIC, 3122, Australia.
Bronte
B
McLeod
Centre for Design Innovation, Swinburne University of Technology, Hawthorn, VIC, 3122, Australia.|Department of Computing and Information Systems, University of Melbourne, Parkville, VIC, 3052, Australia.
Leon
L
Sterling
Centre for Mental Health, Swinburne University of Technology, PO Box 218, Hawthorn, VIC, 3122, Australia.
Greg
G
Murray
Department of Occupational Therapy, Monash University - Peninsula Campus, Frankston, VIC, 3199, Australia.|Living with Disability Research Centre, La Trobe University, Melbourne, VIC, 3086, Australia.
Ellie
E
Fossey
Mind Australia, Heidelberg, VIC, 3084, Australia.|Melbourne School of Population and Global Health, University of Melbourne, Parkville, VIC, 3052, Australia.
Lisa
L
Brophy
Centre for Mental Health, Swinburne University of Technology, PO Box 218, Hawthorn, VIC, 3122, Australia.|Australian National University, Canberra, ACT 2601, Australia.
Michael
M
Kyrios
D000293:Adolescent; D000328:Adult; D000368:Aged; D065026:Hope; D006801:Humans; D008297:Male; D008605:Mental Health Services; D008875:Middle Aged; D011209:Power, Psychological; D011613:Psychotherapy / Q000379:methods*; D011618:Psychotic Disorders / Q000523:psychology / Q000628:therapy*; D011788:Quality of Life; D012648:Self Care / Q000379:methods* / Q000523:psychology; D020377:Self Efficacy; D012919:Social Behavior; D012933:Social Identification; D011795:Surveys and Questionnaires; D017216:Telemedicine / Q000379:methods*; D016896:Treatment Outcome; D014739:Victoria; D055815:Young Adult
Digital health; Illness self-management; Peer support; Personal recovery; Psychosis; Randomised controlled trial (RCT); Schizophrenia; Tablet computers; e-therapy