Social Mind: Improving Social Functioning in First Episode Psychosis

Mental health and social life are intrinsically connected. Bio-psycho-social models of psychosis, based on animal and human studies, point to social stress as a putative mechanism for the emergence of psychotic symptoms. Our own work suggests that people with first episode of psychosis (FEP) experience high levels of social stress, and that this has negative impact on their social interactions. Yet none of the existing psychological interventions for psychosis has an explicit focus on social stress. This project will involve the development and validation of Social Mind, a new psychological intervention aimed at helping patients understand and manage social stress, minimise risk of social withdrawal and improve social interactions. This is achieved by combining the cognitive appraisal of social stress and an active behavioural component involving real-life situations. We will trial Social Mind in a feasibility study with 60 patients recruited from two National Health Service (NHS) Trusts. This feasibility study will compare people who receive Social Mind in addition to routine clinical support against people who receive routine clinical support alone. We will collect quantitative and qualitative information on the feasibility, acceptability, safety and clinical efficacy of Social Mind. This information will be used to refine the intervention and develop a full-scale randomised control trial. Following such full-scale validation, we will have a new evidence-based intervention for reducing social stress and improving social interactions in people with FEP. Social Mind will help people with psychosis to navigate social situations, establish and sustain meaningful social relationships, live a more independent life and fulfil their educational and occupational objectives. This will greatly reduce the burden of the illness on service users, their families and clinical services.

Mental health and social life are intrinsically connected. Bio-psycho-social models of psychosis, based on animal and human studies, point to social stress as a putative mechanism for the emergence and reoccurrence of positive and negative symptoms. Our own work shows that people with first episode of psychosis (FEP) experience high levels of social stress, and that this is predictive of clinical and functional outcomes. Yet none of the existing psychological interventions for psychosis focusses on social stress. This project will involve testing the feasibility of implementing Social Mind, a new psychological intervention aimed at helping patients understand and manage social stress, minimising risk of social withdrawal and promoting social functioning. This is achieved by combining the cognitive appraisal of social stress and an active behavioural component involving real-life situations. Social Mind was co-developed by a diverse team including lived experience experts, mental health professionals and academics. We will trial Social Mind in a feasibility randomised controlled trial with 60 patients recruited from two National Health Service (NHS) Trusts. The feasibility trial will compare Social Mind + Treatment as Usual (TAU) against TAU. Outcomes will assess the feasibility and acceptability of recruitment methods; recruitment rates and participants' willingness to be randomised; the acceptability of assessment measures, intervention mode and intervention delivery; treatment fidelity; follow-up rates; and estimates of sample size parameters. We will use this information to inform a full-scale randomised controlled trial. Following full validation, the present project will lead to a new evidence-based intervention for improving social functioning in people with FEP. This will greatly reduce the burden of the illness on service users, their families and clinical services.