Attachment-focused Imagery Therapy for Psychosis-related Trauma

Abstract

The aim of this thesis was to explore the potential utility of combining attachment theory and imagery techniques in the treatment of psychosis-related trauma (i.e., trauma from the experience of having a psychosis and/or its sequelae). The thesis is presented as three separate papers: a systematic literature review (Paper 1), an empirical study (Paper 2) and a critical reflection of the research process (Paper 3). The systematic review presents an appraisal of trauma measures for use with non-affective psychosis populations, available within the current literature. The instruments were evaluated using the COnsesnus-based Standards for the selection of health Measurement INstruments (COSMIN) methodology. The review identified sixteen distinct instruments across twenty-four papers: nine measured whether trauma had been experienced within the lifespan and seven assessed the impact of trauma in quantifiable symptoms (i.e., Post-Traumatic Stress Disorder symptomology). A distinct lack of consideration for the unique traumatic experiences of psychosis populations was recognised within the available measures. Recommendations are provided for instrument use and thus, a useful resource has been compiled for researchers and clinicians alike. The empirical study examined the feasibility and preliminary clinical outcomes of a novel attachment-focused imagery intervention as a treatment for psychosis-related trauma. A randomised, multiple baseline case series of six sessions of Attachment-focused iMAgery therapy for PSychosis (A-iMAPS) was conducted with twelve participants. Results suggest that A-iMAPS is feasible and safe for use with people with psychosis who have experienced psychosis-related trauma. Varied clinical outcomes were seen but promising trends emerged, including a significant improvement in 'felt security' between baseline and intervention phases. This paper demonstrates that a brief attachment-focused imagery therapy is a promising intervention for targeting psychosis-related trauma, an area in which the intervention literature is currently limited. Finally, paper three provides a critical appraisal of the design, methodology, and decision-making processes which took place. Strengths and limitations are considered, along with the contribution to the literature and suggestions for future research. The paper concludes with personal reflections on the thesis project.

Date of Award	31 Dec 2023
Original language	English
Awarding Institution	The University of Manchester
Supervisor	Katherine Berry (Supervisor) & Christopher Taylor (Supervisor)