Background The trauma-psychosis relationship is well established via the dose-response hypothesis, including the connection between traumatic experiences and psychosis-like experiences (PLE). PLE are commonly associated with childhood trauma and this relationship has been found to be influenced by attachment. Secure attachment can help people manage trauma and, as psychosis can be understood as a trauma-response, secure attachment may also be protective for those with PLE.Methods This study narratively explored traumatic experiences and PLE in the general population. Nine participants, with experience of trauma/adversity and PLEs, and self-defined as "managing well" undertook a narrative interview. Narrative analysis explored how their difficult experiences were managed, through the lens of attachment.Results Common narratives included escape, endurance, overcoming and exploration. Relationships were mostly depicted as helping people manage their experiences, however, unhelpful relationships could understandably exacerbate distress.Discussion The study highlights areas of consideration for clinical practice, including drawing attention to the value of providing space to hear the stories of those who have experienced trauma and PLE.
Background This study investigated the effects of music and drama therapy on cognitive and social functioning and social cognition in participants. Methods Ten people given a diagnosis of schizophrenia were assigned to drama therapy and seven to music therapy. They were administered a sociodemographic form, the Social Functioning Assessment Scale, the Observable Social Cognition Rating Scale, the Mini Positive and Negative Syndrome Scale (8-item version), and the Kocaeli Cognitive Assessment Scale at baseline and at week 8. Results Statistically significant differences were observed between baseline and week 8 scores for SFAS-Self-Care (p = 0.002), SFAS-Interpersonal Relationships and Entertainment (p < 0.001), SFAS-Total (p < 0.001), Mini-PANSS-8-Negative (p = 0.009), KoBD & Ouml; (p < 0.001), and OSCARS (p = 0.005); the differences between the pre- and post-scale scores for the other scales were not significant (p > 0.05). There was no statistically significant difference between the drama therapy and music therapy groups in terms of baseline scale scores (p > 0.05). Similarly, there was no statistically significant difference in scale scores measured in the 8th week between these two groups (p > 0.05). Discussion Based on the results of our study, it is hypothesized that drama and music therapy may have therapeutic efficacy in alleviating negative symptoms and improving social cognition and cognitive abilities in schizophrenia.
Background The STAR (Study of Trauma and Recovery) trial showed that integrating evidence-based therapies for Post-Traumatic Stress Disorder (PTSD) and psychosis resulted in significant improvements in PTSD, psychosis, and emotional difficulties, with exceptionally low disengagement rates.Methods We outline the therapy guide for delivering Trauma-Focused Cognitive-Behaviour Therapy for Psychosis (TF-CBTp) and its therapeutic values, principles, and theoretical underpinnings. Based on theoretical models highlighting the interplay between PTSD and psychosis, the therapy assumes similar underlying psychological mechanisms that are targeted together.Results TF-CBTp comprises four phases: (1) assessment and goal setting; (2) formulation; (3) formulation-driven model-based interventions, consisting of a) rebuilding life, b) promoting control, psychoeducation and emotional regulation and c) addressing trauma memories, anomalous experiences and associated meanings; (4) consolidation and staying well. Throughout therapy, there is a strong emphasis on engagement, developing a strong therapeutic relationship, and fostering a sense of control. Therapy was intended to be delivered over nine months, with approximately 26 weekly/twice-weekly individual sessions offered over 6 months followed by three monthly boosters. However, in practice additional sessions or a longer duration were often required.Discussion Further research should develop and evaluate care pathways to support safe, equitable, and effective implementation of TF-CBTp.
