Patient perceptions of psychological interventions provided on acute psychiatric inpatient wards, and the implementation of Method of Levels therapy for people experiencing psychosis on inpatient wards

Abstract

This thesis explored patient perceptions of psychological interventions provided on acute inpatient wards. The thesis consists of three papers: A systematic literature review, an empirical study, and a critical reflection of the research process. The systematic literature review (Paper 1) is a qualitative thematic synthesis of patient perspectives on psychological interventions provided in adult acute psychiatric inpatient wards. Seventeen studies were included in the review across six countries and including feedback from at least 192 service users. Thematic synthesis produced three superordinate themes and ten subthemes: Connecting with Others, Psychological Processes, and Engaging with the Intervention. The findings provide a service user perspective on helpful and unhelpful aspects of psychological interventions provided on inpatient wards. Therapeutic relationships with others and change mechanisms of focussing, expression, and gaining insight, were important, and service users wanted more support between sessions and with difficult group dynamics in order to benefit from the interventions. Recommendations for future research and clinical practice are provided. The empirical study (Paper 2) is a case series exploring the feasibility and acceptability of Method of Levels (MOL) therapy for people experiencing psychosis and accessing acute mental health inpatient services. Participants were recruited from three acute inpatient wards, and six participants took part in the study. Participants were offered MOL therapy sessions for a therapy window of three months. Three participants took part in qualitative interviews and data was analysed using Interpretative Phenomenological Analysis (IPA). IPA produced three Group Experiential Themes and nine subthemes: Expectations, The Importance of Being Heard, and Experiences of MOL Therapy. Feedback suggested that MOL was an acceptable and feasible intervention for this population and setting, but that more resources were needed to collect follow-up data. Recommendations for future larger-scale studies are provided. The critical reflection (Paper 3) provides an appraisal of the research process. This paper expands on decisions made during the research process, strengths and limitations of both studies and methodologies used, implications for research and clinical practice, and personal reflections on the research process.

Date of Award	17 Oct 2023
Original language	English
Awarding Institution	The University of Manchester
Supervisor	Yvonne Awenat (Co Supervisor) & Sara Tai (Main Supervisor)