None listed
Conditions
Brief summary
A lifetime diagnosis of substance use disorder is seen in 40% of Australians with psychosis, and has substantial symptomatic and functional impacts. Both problems have detrimental effects on motivation, hindering treatment gains. A newly developed intervention, Functional Imagery Training (FIT), uses individually tailored imagery (multisensory mental 'pictures') to consolidate motivation, rehearse coping strategies and enhance confidence. Personal smartphones are used to assist in use of imagery and to set reminders, while the OnTrack Get Real Internet program supports self-management of psychotic symptoms. The current study aims to: 1. Examine the effectiveness of FIT with 20 young adults aged 16-25 years who are experiencing early episode psychosis and using cannabis; 2. Qualitatively explore participants' experiences of the treatment and solicit suggestions for enhancement of the intervention. Participants are recruited from the Early Psychosis Team, Princess Alexandra Hospital. Case managers obtain verbal consent from the consumer to pass on their details to the research team. If the consumer is less than 18 years of age and has a parent/guardian involved in their care, staff also obtain consent from the parent/guardian. The research team contact the consumer to provide more information about the study, and to make an appointment for the baseline assessment. The baseline assessment lasts up to 60 minutes and includes questions about cannabise use, psychiatric history and symptoms, and quality of life. The FIT intervention commences one week later and comprises two face-to-face treatment sessions of 1 hour duration, held one week apart. Sessions combine motivational interviewing with the use of imagery to identify reasons for cannabis reduction, possible goals and strategies, and to build confidence. Imagery involves creation of multisensory mental pictures relating to the goal, reasons for change and success with similar goals in the past. Session 2 concludes with instruction in how their smartphone can be used to assist them to use the intervention techniques in their everyday life. Treatment support phone calls of 10-15 minutes occur in weeks 3, 4, 8 and 12 after baseline. Support calls reinforce goal committment and problem-solve difficulties. Cannabis use and goal motivation are also assessed in the 4 week call. A follow-up interview of 60 minutes duration occurs 13 weeks post-baseline and assesses cannabis use, psychiatric symptoms, quality of life, and experiences of the treatment. Throughout FIT, participants remain engaged with routine care and are encouraged to use the OnTrack Get Real Internet program for assistance with their psychiatric symptoms.
Interventions
The current study aims to test the effectiveness of a newly developed, technology-assisted, motivational intervention in a sample of consumers with early psychosis (within first 3 episodes and first 3 years) and co-occuring cannabis use. The study objectives are to:
1. Deliver the Functional Imagery Training (FIT) intervention to 20 young adults aged 16-25 years who are experiencing early episode psychosis and using cannabis;
2. Qualitatively explore participants' experiences of the treatment a
The current study aims to test the effectiveness of a newly developed, technology-assisted, motivational intervention in a sample of consumers with early psychosis (within first 3 episodes and first 3 years) and co-occuring cannabis use. The study objectives are to: 1. Deliver the Functional Imagery Training (FIT) intervention to 20 young adults aged 16-25 years who are experiencing early episode psychosis and using cannabis; 2. Qualitatively explore participants' experiences of the treatment and solicit suggestions for enhancement of the intervention. Functional Imagery Training (FIT) implements theoretical and empirical advances in our understanding of motivation, and how it is maintained. It retains the spirit and typical elements of motivational interviewing, but employs imagery throughout face-to-face sessions, and uses a smartphone to cue both functional motivations and related behaviours in the natural environment. Personal pictorial libraries are stored on the phone to cue imagery and functional motivations ('What will get better'), plans for risk situations ('What I'll do') and personal achievements ('My successes'). Expected benefits of control focus on proximal, probable and highly valued outcomes - features that maximise impact and are easily imagined. Plans for risky situations include fun activities that are inconsistent with cannabis use, and activities that demand concentration (to reduce craving imagery). Consumers nominate risky times when they want to receive self-generated messages or pictorial icons to help maintain control. Ideas of the personal libraries at the initial session may not match what actually occurs, so consumers add images and short videos to remind them of actual positive changes, effective plans and relevant successes. Daily personal experiences are captured and tagged for use in the libraries. Consumers augment the affective impact of experienced benefits by projecting them into the future and develop alternate imaginal 'TV adds' to keep them fresh. The FIT intervention comprises two face-to-face treatment sessions of 1 hour duration, held one week apart. Sessions combine motivational interviewing with use of imagery to identify reasons for cannabis reduction, possible goals and strategies, and build confidence. Imagery involves creation of multisensory mental pictures relating to the goal, reasons for change and success with similar goals in the past. Session 2 concludes with instruction in how their smartphone can be used to assist them to use the intervention techniques in their everyday life. Treatment support phone calls of 10-15 minutes occur in weeks 3, 4, 8 and 12. In view of difficulties with appointment-keeping in this group, after initial sessions, FIT is delivered by phone. Support calls reinforce goal comittment and problem-solve difficulties. It is hypothesised that participants will report significantly fewer occcassions of cannabis use in the 3 months following treatment compared to the 3 months before treatment, as well as a reduction in psychotic symptom severity and improvement in overall quality of life.
Sponsors
Prof David Kavanagh
Study design
Allocation
Non-randomised trial
Intervention model
Single group
Primary purpose
Treatment
Masking
Open (masking not used)
Eligibility
Sex/Gender
All
Age
16 Years to 25 Years
Healthy volunteers
No
Inclusion criteria
Key inclusion criteria are as follows: 1. Aged 16 to 25 years; 2. Current episode of a DSM-5 psychotic disorder; 3. No more than 2 prior episodes of psychosis, and within 3 years of initial episode; 4. At least 28 days of cannabis use in the previous 3 months as assessed by a Timeline Follow-Back; 5. Score of at least 1 on the DrugCheck Problem List for cannabis use; 6. Access to a smartphone capable of taking and storing photos, and of setting calendar tasks and reminders; 7. Sufficient English to give informed consent and to participate in the study without translation (assessed based on observation).
Exclusion criteria
Key exclusion criteria are as follows: 1. Scoring greater than 0 on the DrugCheck Problem List for substances other than cannabis (excluding nicotine and caffeine); 2. Injected use of any drug in the previous 4 weeks (excluding prescribed anti-psychotic medication); 3. Presence of permanent cognitive impairment that would impair ability to give informed consent (such as brain injury or intellectual ability - assessement based on observation and knowledge of consumer).
Outcome results
None listed