iMAgery focused psychological therapy for persecutory delusions in PSychosis (iMAPS): A multiple baseline experimental case series

Background: Many people with psychosis experience persecutory delusions and report negative schematic beliefs and intrusive mental images which may be maintaining factors for psychotic symptoms. Aims: This study examined the feasibility and acceptability of a new psychological therapy targeting schemas and images (iMAPS therapy).
Method: The study used a randomised multiple baseline design. Participants with first episode psychosis were randomised using a multiple baseline design with 2
– 5 assessments. Six sessions of therapy, consisting of a combination of imagery techniques and imagery rescripting techniques, was used. In each session, participants completed a Mental Imagery in Psychosis Questionnaire (MIPQ) and imagery interview. Mood and delusional beliefs (PSYRATS) were also measured at each session.
Results: Five participants with first episode psychosis completed the baseline visits and attended all therapy sessions. One participant declined the final assessment. Results demonstrated significant reductions in
negative schematic beliefs, delusions, imagery distress and other measures of schema (YSQ, SMI). Although multiple baseline randomisation strengthens the study, it lacked a control arm and blind assessments. Conclusions: iMAPS appears a feasible and acceptable treatment for psychosis, and further evaluation is
indicated.