Are we almost there? A mixed methods exploration of attendance, engagement, and outcomes in an online group intervention for first-episode psychosis
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Authors
Simioni, Olivia
Date
2024-10-04
Type
thesis
Language
eng
Keyword
Psychosis , Early Intervention , Treatment Engagement , Mixed Methods , Online Treatment
Alternative Title
Abstract
Background: The COVID-19 pandemic brought to light the limited online treatment options for individuals with psychosis, despite the potential for this modality to improve access to specialized interventions. Some research examining online group interventions was conducted during the pandemic, however much of the focus was on acceptance and feasibility, and little remains known about how individuals with psychosis attend, engage with, and benefit from online group interventions. As individuals with psychosis often struggle to engage with existing healthcare models, it is essential to explore the factors that facilitate attendance and engagement. As such, the current study utilized a mixed methods design to explore attendance, engagement, and outcomes, as well as service users’ perspectives of an online group intervention.
Methods: Fifty-one individuals with first-episode psychosis took part in an eight-session online group intervention for self-stigma. Self-reported anxiety, mood, beliefs about recovery, self-esteem, and internalized stigma were assessed before and after the intervention. Engagement was coded from clinical notes based on individuals’ verbal participation during in-session activities. Eight individuals who completed the intervention took part in the qualitative study. Semi-structured interviews were conducted to explore participants’ experiences with the online intervention, and the data were analysed using coding reliability thematic analysis.
Results: On average, participants attended 76% of sessions and made some novel verbal contributions throughout the intervention. Neither attendance nor engagement were related to baseline symptom severity or beliefs about recovery. Level of engagement was not associated with change in self-stigma across the intervention, despite significant reductions in self-stigma. Exploratory analyses highlighted an interaction between engagement and change in secondary outcomes. Two topic summaries were identified from qualitative interviews: barriers and facilitators of attendance and features of online engagement. Sub-topics echoed quantitative findings, with participants reporting that the convenience of the online format promoted attendance, while levels of comfort engaging varied across participants.
Conclusions: The findings further highlight the potential for online group interventions for individuals with psychosis. Although engagement remains a challenging construct to measure, the results call to attention the potential role of verbal engagement in online interventions, warranting further research.
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ProQuest PhD and Master's Theses International Dissemination Agreement
Intellectual Property Guidelines at Queen's University
Copying and Preserving Your Thesis
This publication is made available by the authority of the copyright owner solely for the purpose of private study and research and may not be copied or reproduced except as permitted by the copyright laws without written authority from the copyright owner.
Attribution-NonCommercial-NoDerivatives 4.0 International