Motivational Interviewing for Patients With Acute Psychosis

NCT05911529 | Completed DMC

• 1 other identifier: MI for acute psychosis
• Study Type: interventional
• Target: 28
• Locations: 1 country
• Sites: 1

Brief Summary

Psychotic disorders are associated with high levels of distress, limitations in quality of life, and a high risk of chronification for those affected. The treatment guidelines recommend combining the pharmacological treatment with psychotherapeutic methods, starting already in the acute phase. At the same time, there is little research evidence on which mechanisms of psychotherapy are most effective and best feasible for the acute setting. Therefore, the aim is to run a pilot study to test specific psychotherapeutic interventions for patients with psychosis on acute psychiatric wards. The method of "Motivational Interviewing" is a well-known and established interviewing technique, which originally comes from the treatment of addictive disorders. In this study, it is used to strengthen the therapeutic alliance between patient and practitioner already in the acute phase of the disease, to increase adherence, and thus to achieve the overall goal of better integrating patients with pronounced positive symptoms into treatment. This appears to be extremely important, as non-adherence represents one of the greatest risks for chronification of the disease. The intervention will subsequently be evaluated in comparison to "treatment as usual".

Conditions

Psychosis; Schizophrenia

Keywords

Psychosis; Motivational Interviewing; Psychotherapy for psychosis; Adherence to treatment; Therapeutic alliance; Acute phase

Outcome Measures

Primary Outcomes (2)

• Change from Baseline in Therapeutic Alliance on the Scale to Assess Therapeutic Relationship

  The therapeutic relationship will be evaluated with the german version of the Scale to Assess Therapeutic Relationship (STAR). The patient (STAR-P) and clinician scales (STAR-C) each have 12 items comprising three subscales: positive collaboration and posi-tive clinician input in both versions, non-supportive clinician input in the patient version, and emotional difficulties in the clinician version.

  Baseline and week 3 (or after 4 sessions of psychotherapeutic intervention)

• Change from Baseline in Treatment Adherence on the Brief Adherence Rating Scale

  The Brief Adherence Rating Scale (BARS) is a brief, pencil-paper, clinician-administered adherence assessment instrument. It consists of 4 items: 3 questions and an overall visual analog rating scale to assess the proportion of doses taken by the patient in the past month (0%-100%).

  Baseline and week 3 (or after 4 sessions of psychotherapeutic intervention)

Secondary Outcomes (3)

• Change from Baseline in Symptom Severity measured with the Positive and Negative Syndrome Scale

  Baseline and week 3 (or after 4 sessions of psychotherapeutic intervention)

• Change from Baseline in Motivation for psychotherapy in the Questionnaire to measure the motivation for psychotherapy

  Baseline and week 3 (or after 4 sessions of psychotherapeutic intervention)

• Change from Baseline in Self-Efficacy on the General Self-Efficacy Scale

  Baseline and week 3 (or after 4 sessions of psychotherapeutic intervention)

Study Arms (2)

Motivational Interviewing Group

EXPERIMENTAL

Patients will receive four sessions of Motivational Interviewing within two weeks.

Behavioral: Motivational Interviewing

Control Group

ACTIVE COMPARATOR

Patients in the control group receive four sessions of supportive conversations within two weeks.

Behavioral: Supportive conversations

Interventions

Motivational Interviewing BEHAVIORAL

In our study intervention, patients should receive four session of motivational interviewing (MI). Throughout the MI sessions, interviewers use common MI techniques including open-ended questions, affirmations, reflections, summaries, asking permission, expressing empathy, supporting self-efficacy, etc. Interviewers are clinical psychologists who received MI training immediately prior to the study.

Motivational Interviewing Group

Supportive conversations BEHAVIORAL

In the control intervention patients should also be given four sessions, in which no MI techniques take place. They will be carried out in the sense of supportive conversations (i. e. conver-sations that do not follow a specific psychotherapy concept). Since we want to check whether the patients really benefit from the specific intervention and not from getting more speaking time, the patient in the control group will also be given four conver-sations. It is known that supportive conversations can have a certain effect on the well-being and recovery process of patients, as the therapeutic relationship, i.e. appreciation, attention and/or attention, is an important efficacy factor (e. g. Grawe, 1995).

Control Group

Eligibility Criteria

• Age: 18 Years - 65 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Informed consent as documented by signature
• Male and female patients from inpatient units of the Psychiatric University Hospital of Zurich
• ICD-10 diagnosis of psychosis (F2.x)
• Fluent in German and able to understand the instructions

You may not qualify if:

• Organic schizophrenia-like disorder (ICD: F0.6)
• Drug or alcohol abuse during treatment
• Previous enrolment in the current study
• Enrolment of the investigator, his/her family members, employees and other dependent persons
• During study: Complete stop of taking antipsychotic medications

Sponsors & Collaborators

• Psychiatric University Hospital, Zurich: lead

Study Sites (1)

Psychiatric University Hospital Zurich

Zurich, 8032, Switzerland

Location

Related Publications (24)

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MeSH Terms

Conditions

Psychotic Disorders; Schizophrenia; Treatment Adherence and Compliance

Interventions

Motivational Interviewing

Condition Hierarchy (Ancestors)

Schizophrenia Spectrum and Other Psychotic Disorders; Mental Disorders; Health Behavior; Behavior

Intervention Hierarchy (Ancestors)

Directive Counseling; Counseling; Mental Health Services; Behavioral Disciplines and Activities; Health Services; Health Care Facilities Workforce and Services

Study Officials

• Philipp Homan, Prof.

  University of Zurich

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: SINGLE
• Who Masked: PARTICIPANT
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Clinical psychologist, PhD

Study Record Dates

• First Submitted: May 2, 2023
• First Posted: June 22, 2023
• Study Start: March 15, 2023
• Primary Completion: December 31, 2023
• Study Completion: December 31, 2023
• Last Updated: July 16, 2024

Record last verified: 2024-07

Data Sharing

• IPD Sharing: Will not share

Locations

CH (1)