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SlowMo therapy, a new digital blended therapy for fear of harm from others: An account of therapy personalisation within a targeted intervention
Author(s) -
Ward Thomas,
Hardy Amy,
Holm Rebecca,
Collett Nicola,
RusCalafell Mar,
Sacadura Catarina,
McGourty Alison,
Vella Claire,
East Anna,
Rea Michaela,
Harding Helen,
Emsley Richard,
Greenwood Kathryn,
Freeman Daniel,
Fowler David,
Kuipers Elizabeth,
Bebbington Paul,
Garety Philippa
Publication year - 2022
Publication title -
psychology and psychotherapy: theory, research and practice
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.102
H-Index - 62
eISSN - 2044-8341
pISSN - 1476-0835
DOI - 10.1111/papt.12377
Subject(s) - mindfulness , worry , rumination , psychology , psychotherapist , coping (psychology) , paranoia , safer , clinical psychology , art therapy , anxiety , psychiatry , cognition , computer security , computer science
Objectives SlowMo therapy is a pioneering blended digital therapy for paranoia, augmenting face‐to‐face therapy with an interactive ‘webapp’ and a mobile app. A recent large‐scale trial demonstrated small–moderate effects on paranoia alongside improvements in self‐esteem, worry, well‐being and quality of life. This paper provides a comprehensive account of therapy personalisation within this targeted approach. Design Case examples illustrate therapy delivery and descriptive data are presented on personalised thought content. Method Thought content was extracted from the webapp ( n = 140 participants) and coded using newly devised categories: Worries: (1) Persecutory, (2) Negative social evaluation, (3) Negative self‐concept, (4) Loss/life stresses, (5) Sensory‐perceptual experiences and (6) Health anxieties. Safer thoughts: (1) Safer alternative (specific alternatives to worries), (2) Second‐wave (generalised) coping, (3) Positive self‐concept, (4) Positive activities and (5) Third‐wave (mindfulness‐based) coping. Data on therapy fidelity are also presented. Results Worries: ‘Persecutory’ (92.9% of people) and ‘Negative social evaluation’ (74.3%) were most common. ‘General worries/ life stresses’ (31.4%) and ‘Negative self‐concept’ (22.1%) were present in a significant minority; ‘Health anxieties’ (10%) and ‘Sensory‐perceptual’ (10%) were less common. Safer thoughts: ‘Second‐wave (general) coping’ (85%), ‘Safer alternatives’ (76.4%), ‘Positive self‐concept’ (65.7%) and ‘Positive activities’ (64.3%) were common with ‘Third‐wave’ (mindfulness) coping observed for 30%. Fidelity: Only three therapy withdrawals were therapy related. Session adherence was excellent (mean = 15.2/16; SD = 0.9). Behavioural work was conducted with 71% of people (119/168). Conclusion SlowMo therapy delivers a targeted yet personalised approach. Potential mechanisms of action extend beyond reasoning. Implications for cognitive models of paranoia and causal interventionist approaches are discussed.