title: A brief CBT intervention for depersonalisation/derealisation in psychosis: study protocol for a feasibility randomised controlled trial.
abstract: BACKGROUND
  Depersonalisation is the experience of being detached or disconnected from one's experience. Studies suggest that clinically significant levels of depersonalisation are common in individuals who have psychotic symptoms and are associated with increased impairment. However, to date, there have been no studies that have investigated an intervention designed to target clinically significant depersonalisation in such patient groups. This study aims to determine the feasibility and acceptability of a brief intervention targeting clinically significant depersonalisation in those who also have current psychotic symptoms.
  
  
  METHODS
  The feasibility of delivering six sessions of cognitive behavioural therapy for depersonalisation in psychosis patients will be evaluated using a single-blinded randomised controlled trial with a treatment as usual control condition. Participants will be assessed at baseline and then randomised to either the treatment or control arm. Participants randomised to the treatment arm will be offered six sessions of individual cognitive behavioural therapy delivered over a maximum of 10 weeks. Therapy will focus on an individualised shared formulation of depersonalisation experiences and behavioural, cognitive, emotional regulation and thinking process strategies to decrease distress associated with depersonalisation. Participants will be assessed again at a 10-week (post-randomisation) follow-up assessment. The primary outcomes of interest will be those assessing the feasibility and acceptability of the intervention including rates of referral, eligibility and acceptance to participate; attendance at therapy sessions and completion of homework tasks; satisfaction with the intervention; maintenance of blinding; and therapist competence. Secondary outcomes will be data on clinical outcome measures of depersonalisation and positive symptoms of psychosis, anxiety, depression and post-traumatic stress.
  
  
  CONCLUSIONS
  This study will determine the feasibility of delivering six sessions of cognitive behavioural therapy for individuals with current psychotic symptoms who also experience clinically significant levels of depersonalisation. The results will provide information to inform a larger randomised trial to assess intervention efficacy.
  
  
  BACKGROUND
  ClinicalTrials.gov NCT02427542.
authors.affiliation: Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.
authors.forename: Simone
authors.initials: S
authors.lastname: Farrelly
authors.affiliation: Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK ; NIHR Biomedical Research Centre for Mental Health, South London and Maudsley NHS Foundation Trust, London, UK.
authors.forename: Emmanuelle
authors.initials: E
authors.lastname: Peters
authors.affiliation: Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.
authors.forename: Matilda
authors.initials: M
authors.lastname: Azis
authors.affiliation: NIHR Biomedical Research Centre for Mental Health, South London and Maudsley NHS Foundation Trust, London, UK ; Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.
authors.forename: Anthony
authors.initials: A
authors.lastname: David
authors.affiliation: Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK ; NIHR Biomedical Research Centre for Mental Health, South London and Maudsley NHS Foundation Trust, London, UK.
authors.forename: Elaine C
authors.initials: EC
authors.lastname: Hunter
keywords: Cognitive behaviour therapy; Depersonalisation; Derealisation; Feasibility trial; Intervention; Psychosis