OBJECTIVE:Given the potential severity of developing chronic mental health problems, particular attention has been paid to the first emergence of psychosis. Earlier detection is expected to lead to quicker access to the effective treatment that is necessary during the 'critical period' and is one of the main incentives for setting up early intervention in psychosis (EIP) services. EIP services have demonstrated good clinical outcomes since inception, but little is understood yet as to which specific element of EIP leads to these good outcomes. The aim of this research was to conduct an exploratory investigation of the elements that people experiencing a first episode of psychosis find most valuable about EIP treatment.DESIGN:The study employed a single group design and utilized Q-methodology.METHOD:20 people with first-episode psychosis aged between 18 and 35 were recruited and asked what they valued most about EIP.RESULTS:Four separate factors were identified, which were interpreted and named as 'therapeutic relationship', 'medical care', 'psychological interventions', and 'support, coping and recovery'. Three of the factors were consistent with a biopsychosocial approach of EIP that is recommended by expert professionals working in EIP services and Government guidance on service delivery.CONCLUSIONS:The factor that accounted for the most variance is 'therapeutic relationship', highlighting the importance of non-specific factors in mental health care and recovery from a first episode of psychosis.PRACTITIONER POINTS:Service users reported that four main components of Early Intervention in Psychosis Services were helpful to them. These included a strong and effective therapeutic relationship, as well as medication, psychological therapies, and practical help and support. Services are valued both for the quality of the therapeutic relationship but also for their ability to deliver meaningful and valued treatments in this context.

Given the potential severity of developing chronic mental health problems, particular attention has been paid to the first emergence of psychosis. Earlier detection is expected to lead to quicker access to the effective treatment that is necessary during the ‘critical period’ and is one of the main incentives for setting up early intervention in psychosis (EIP) services. EIP services have demonstrated good clinical outcomes since inception, but little is understood yet as to which specific element of EIP leads to these good outcomes. The aim of this research was to conduct an exploratory investigation of the elements that people experiencing a first episode of psychosis find most valuable about EIP treatment. The study employed a single group design and utilized Q-methodology. 20 people with first-episode psychosis aged between 18 and 35 were recruited and asked what they valued most about EIP. Four separate factors were identified, which were interpreted and named as ‘therapeutic relationship’, ‘medical care’, ‘psychological interventions’, and ‘support, coping and recovery’. Three of the factors were consistent with a biopsychosocial approach of EIP that is recommended by expert professionals working in EIP services and Government guidance on service delivery. The factor that accounted for the most variance is ‘therapeutic relationship’, highlighting the importance of non-specific factors in mental health care and recovery from a first episode of psychosis.

AIM:People with psychotic symptoms are reported to have a characteristic reasoning style in which they jump to conclusions (JTC). The aims of this research were threefold. The first was to establish how prevalent this style is in people with first-episode psychosis. The second was to examine the specificity of JTC to delusions. The third was to examine explanatory factors that may account for the JTC style. This was investigated by attempting to replicate, with a large sample, previous studies indicating that JTC is associated with specific psychotic and non-psychotic symptoms and processes.METHODS:Seventy-seven service users were recruited from a first-episode service and completed measures of reasoning and psychotic and non-psychotic symptomatologies. A well-established criterion was used to compare the JTC performance of those people with and without JTC.RESULTS:JTC was present in over 40% of the sample, which is consistent with previous studies of people with long-standing psychotic symptoms. Unlike previous research, no strong associations were found in relation to symptoms and other processes.CONCLUSIONS:JTC is a phenomenon common in many people in first-episode services. In this large cohort sample, no clear associations with symptoms or other psychological processes were evident. Hence, the reason people JTC is still unclear.

Introduction. People with delusional beliefs "jump to conclusions" (JTC). This finding is well replicated. However, there is only limited exploration of the factors that might lead a person to JTC. The aim of the present study was to explore the contribution of working memory processes (WM) and IQ to hasty decision making and to investigate the stability of this bias over time.Methods. A single group cross-sectional design was utilised. The study was conducted in 2 phases: (1) an initial screening phase and (2) an experimental phase whereby we explored and tested hypotheses regarding the cognitive origins of the JTC bias. In Study 1, participants completed the beads task as well as measures of mood and symptoms. In Study 2, the same participants repeated the beads task, and completed a battery of neuropsychological tests designed to assess different facets of WM and IQ.Results. In most cases, "jumpers" were indistinguishable from "nonjumpers" in terms of their neuropsychological profiles. The only exception to this pattern was for visual working memory, in which "jumpers" performed better than "nonjumpers". In terms of the temporal stability of the JTC bias, 8 individuals (out of the 29) effectively switched from being "jumpers" at T1 to "nonjumpers" at T2.Conclusions. This study casts doubt on reduced global WM as an explanation of JTC. Rather it may be that the differences in reasoning are related to the manipulation of visual material and do not extend to other areas of neuropsychological functioning. However, as our sample is small it may be underpowered to detect important differences. Future work is therefore needed to replicate these findings.

This pilot study aimed to explore the clinical outcomes and therapeutic relationship for clients of an adult mental health service using Beating the Blues, a computerised cognitive behaviour therapy (CCBT) package. Sixteen participants completed the programme and reported a significant reduction in Beck Depression Inventory scores posttreatment. Participants' mean item ratings on the relationship measure were above the neutral midpoint, but no association was found between the therapeutic relationship and outcome. The results are discussed in terms of the utility of CCBT as part of a stepped-care model and how further research might usefully explore the nature of the relationship formed between clients and CCBT programmes.