Background: Group-based life coaching intervention is new in mental health service to promote early functional recovery. This study explored the experience of a 10-week group-based life coaching intervention for patients with schizophrenia from the users’ perspective. Method: A qualitative methodology was used based on individual interviews. Four participates referred by the coach were successfully engaged. The materials were taped and transcribed. Result: Seven categories forming four main themes were identified: the usefulness of the coaching intervention; characteristic of goals, subjective feeling during and after the coaching intervention; and perceived changes afterward. Conclusion: Participants were satisfied with the experience through the coaching intervention. They adopted the tactics acquired to cope with the life events and clinical symptoms such as positive and negative psychotic symptoms. Successful attainment of desirable career was their common goals which were facilitated by the sense of achievement continuously encountered during the intervention. Positive changes in both personal and interpersonal level were recorded and thus increased the courage to pursue their ultimate careers. Peer support in group-based intervention enhanced the perseverance towards the pathway to goal attainment. Dependence on the coaches after intervention was observed which was contradictory to one of the aims of life coaching. This study examined the possibility of the implementation of this newly developed intervention in mental healthcare setting in addition to the currently available psychological interventions. Further research directions to improve the utility and explore the domain of recovery are suggested. / published_or_final_version / Psychological Medicine / Master / Master of Psychological Medicine

Background: For early psychosis patients, the first few years were critical period for determining long-term illness outcome. The first experience of admission had significant bearing on the perception of subsequent psychiatric treatment received. From this perspective, it was important to be aware of how patients suffered and how they coped in order to regain their sense of self of insight and treatment adherence and trust with nurses’ rapport and their therapeutic relationship. In this regard, a qualitative study was done with an aim to (i) explore the admission experiences and beliefs participants held upon admission and after discharged within two months. (ii) any influences on their perceptions of experience during and after admission which might impact on therapeutic relationship and treatment attitude Method: Eight ICD-10 first-episode psychosis (FEP) patients aged between 18 and 55 years who admitted to psychiatric inpatient unit for the management of their FEP were recruited. Two face-to-face in-depth interviews were conducted for each participant. First interview was conducted within 2 weeks of admission, while second interview was conducted during psychiatric outpatient follow-up appointment within two months after discharged from hospital. All interviews were audiotaped and transcribed. Thematic analysis was employed to derive common themes regarding patients’ experience and perception on psychiatric hospitalization for their FEP. Results: Thematic analysis revealed six main themes regarding patients’ subjective experience and perception on the illness and hospitalization. These were uncontrollable sense of self, supportive relationship with family members, unpleasant admission procedure, and feeling out of control during hospitalization, perceived benefits of admission, and perceived adverse impacts of admission. Conclusion: Our findings indicated that ideas about what constitute admission perception needed to take into account of patient’s views and experience in order to emphasize therapeutic optimism rather than pessimism, and to inform treatment contexts and the views of nursing staff. / published_or_final_version / Psychological Medicine / Master / Master of Psychological Medicine

Graduation date: 2004

Thesis (Ph. D.)--Drexel University, 2004. / Includes abstract and vita. Includes bibliographical references (leaves 56-65).

Early intervention in psychosis emerged in the 1980s and has gradually become a new paradigm in mental health service worldwide. Yet, very few studies on the history of early intervention in mental illness exist even to date. This dissertation explored the situation in 19th century England when Britain was the only superpower in the world and at the same time was plagued by the rising number of insanity cases that she could only cope with by building more and bigger asylums. The idea of early treatment of insanity was found in various publications written by different physicians in the first half of 19th century. A few of them also proposed primary preventive measures as they believed that a good and disciplined life style could help to avoid the illness. They also saw that insanity could be hereditary. Meanwhile, the debate over the nature of insanity whether it is purely biological or goes beyond the physical body was happening in England as in continental Europe. The physicians supporting the idea of early intervention were also those who subscribed to the theory that insanity has a biological origin. The staging concept in the development of mental illness was well conceived by some physicians. There were also attempts to identify the symptoms in incipient insanity which is close to the modern concept of prodromal stage. Some medical professions also put forward detailed theories on the pathology of the illness based on their knowledge on brain physiology and its interaction with other organs of the body. During this period, professionalization of psychiatrists was advancing. In this process, there was clash between two schools of thoughts. One considered that the profession should move along a scientific path while the other considered that more effort should be devoted to pragmatic issues such as those concerning asylum management. This conflict had in some way hindered the advancement of early treatment. Another major obstacle to the provision of early treatment was the distrust of the society towards psychiatrists. After a number of notorious cases involving people being wrongly confined in the asylums had been widely publicized, the law was tightened to limit the authority of psychiatrists in certifying insanity and in treating uncertified cases. This had resulted in a serious blockade on the road to early treatment. Stigmatization of mental illness in the society was also a major factor in deterring people from seeking early assistance. From the experience in 19th century England, it was found that medicalization of mental illness, professionalization of psychiatrists, establishment of mutual trust between psychiatrists and the society, as well as de-stigmatization of mental illness would be conducive to the development of an early intervention paradigm. / published_or_final_version / Psychological Medicine / Master / Master of Psychological Medicine

Background: A study of the impact of yoga and aerobic exercise and psychosis was conducted in 2012 by Lin et al., from The University of Hong Kong. The study indicated significant improvement in the aspects of physical fitness, cognitive functions, psychosocial and emotional functioning in patients with psychosis after a 12-week yoga or aerobic intervention program. Long-term effect of exercise intervention, however, had yet been determined. The aim of the present study was to evaluate the long-term effects of yoga and aerobic exercise on cognitive functioning and clinical symptoms in early psychosis. Patients who originally participated in Lin et al.’s 2012 study were recruited and re-assessed in this current 18-month follow-up study. Methods: Two intervention groups (yoga and aerobic exercise group) and one control group (wait-list control group) of a total 57 subjects from the initial study were recruited in this follow-up study. Cognitive functioning and clinical symptoms were assessed at three time points (T1:Baseline, T2:12-week, T3:18-month). Results: No significant changes or significant deterioration were found in cognitive functioning, clinical symptoms and depression between T2 (12-week) and T3 (18-month) in both intervention groups (yoga and aerobic group). Significant improvement of clinical symptoms was observed in wait-list control group at T3. Conclusions: Although there is no significant finding in this current study, it is still recommended that further study on the relationship between physical exercise intervention and psychosis should carried out in order to explore other adjunct, and especially low cost, treatment to antipsychotics in treating people with psychosis. / published_or_final_version / Psychological Medicine / Master / Master of Psychological Medicine

Major psychotic disorders are one of the leading causes of disability worldwide, having severe impacts on the people who suffer from the conditions, their families and society. There is evidence that if these conditions are identified and treated early, the prognosis is improved. The purpose of this dissertation study is to produce two manuscripts related to the use of family aided community treatment (FACT) with individuals who are experiencing early psychotic disorders. Using a proof of concept design with multiple repeated-measure t tests, this study focused on first-episode psychotic disorder participants (n = 8), with an average age of 19.6 (sd = 3.28) and males comprising 75% of the sample engaged in a family aided community treatment (FACT) protocol in order to examine if psychiatric symptoms scale scores decreased post-intervention. The hypothesis which stated that a year-long family aided community treatment (FACT) intervention would reduce psychiatric symptoms when assessed by the Structured Interview for Prodromal Syndromes (SIPS), the Positive and Negative Symptoms Scale (PANSS), and the Global Functioning Scales in a first episode psychotic disorder sample, is supported. The FACT intervention decreased psychiatric symptom scores in this population. Implications of this study include improved training on early recognition for mental health clinicians and students, implementation of a specific treatment model in community settings, and policy around treatment funding allocation. / Graduation date: 2012

Programs providing interventions for early psychosis are becoming commonplace in the United States (US); however the terrain of existing services within programs remains undocumented. Unlike other countries, the US does not have a systematic approach to defining and treating this population. We examined program characteristics, clinical services, and treatment population parameters for early intervention programs across the US. A semi-structured telephone interview was conducted with program directors between July 2013 and April 2014. Content analysis was used to identify the presence or absence of 32 evidenced based practices recently recommended for early intervention programs (Addington, et al., 2013). Frequent client requests were identified and functional definitions of the population served were assessed. A total of 34 eligible programs were identified; 31 (91.2%) program representatives agreed to be interviewed. Of the 32 essential components, the most prevalent were individual psychoeducation and outcomes tracking; the least prevalent were outreach services and communication with inpatient units. The population was most frequently defined by age restrictions, and restrictions on the duration of psychosis. Emergent themes of client requests included functional and social recovery as well as help meeting practical needs. Findings have the ability to assist researchers and policy-makers in determining best practice models and creating measures of fidelity. This study provides critical feedback on services for the early psychosis population and identifies research to practice gaps and areas for improvement moving forward.