THE UNIVERSITY of EDINBURGH

DEGREE REGULATIONS & PROGRAMMES OF STUDY 2018/2019

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DRPS : Course Catalogue : School of Health in Social Science : Clinical Psychology

Postgraduate Course: Psychological Approaches to Psychosis (CLPS11062)

Course Outline
SchoolSchool of Health in Social Science CollegeCollege of Humanities and Social Science
Credit level (Normal year taken)SCQF Level 11 (Postgraduate) AvailabilityAvailable to all students
SCQF Credits20 ECTS Credits10
SummaryThe course provides an intensive introduction to working psychologically with individuals distressed by psychotic experience. Psychological Approaches to Psychosis is suited to DClinPsychol trainees or suitably qualified visiting students who wish to develop expertise with this population. The course provides a mix of seminar based teaching and 'masterclass' clinical workshops requiring a high degree of participation. In addition to reviewing and critically appraising relevant psychological literature pertaining to this client group, there will be a particular focus on acquiring clinical skills in assessment, formulation and interventions as applied to this population.
Course description The course provides an intensive introduction to working psychologically with individuals distressed by psychotic experience. Psychological Approaches to Psychosis is suited to DClinPsychol trainees or suitably qualified visiting students who wish to develop expertise with this population. The course provides a mix of seminar based teaching and 'masterclass' clinical workshops requiring a high degree of participation. In addition to reviewing and critically appraising relevant psychological literature pertaining to this client group, there will be a particular focus on acquiring clinical skills in assessment, formulation and interventions as applied to this population.

Teaching content includes:
- Introduction to Psychological Approaches to Psychosis
- Assessment workshop
- Goal setting, problem lists and formulation
- CBTp workshop (normalizing, hallucinations, delusions)
- Affect regulation/recovery/attachment
- Negative symptoms and social recovery
- Pharmacological issues/capacity
- Family Interventions workshop
- Lived experience and carer's perspective seminars
- Cognitive Interpersonal Therapy for Bipolar Disorder Workshop
Entry Requirements (not applicable to Visiting Students)
Pre-requisites Co-requisites
Prohibited Combinations Other requirements The course is only open to students on the DClinPsychol and MSc in Psychological Therapies programmes
Information for Visiting Students
Pre-requisitesVisiting students must be suitably qualified health professionals (e.g. psychologist, nursing, OT, psychiatrist) who have existing experience (minimum 6 months) of working psychological with individuals with psychosis and knowledge/experience of CBT.
High Demand Course? Yes
Course Delivery Information
Academic year 2018/19, Available to all students (SV1) Quota:  None
Course Start Semester 2
Course Start Date 14/01/2019
Timetable Timetable
Learning and Teaching activities (Further Info) Total Hours: 200 ( Lecture Hours 18, Seminar/Tutorial Hours 7, Supervised Practical/Workshop/Studio Hours 20, Programme Level Learning and Teaching Hours 4, Directed Learning and Independent Learning Hours 151 )
Assessment (Further Info) Written Exam 0 %, Coursework 100 %, Practical Exam 0 %
Additional Information (Assessment) A written assignment (which may be based on clinical case material OR involve a review essay) (4,000-5,000 words) - 100%
Feedback Participation in role play is required on a minimum of 3 days during the face to face teaching component. Formative feedback will be provided by tutors and peers during role play sessions. During the CBTp workshop, feedback will be provided to individuals using the Cognitive Therapy Rating Scale (CTRS).
Participants will also be required to engage in an online discussion, analyzing the content of video role plays using the CTRS. The discussion will be facilitated by a tutor who will provide feedback to the cohort.
No Exam Information
Learning Outcomes
On completion of this course, the student will be able to:
  1. Demonstrate a critical understanding of a developmentally informed psychopathological approach to psychosis and enduring mental health problems.
  2. Demonstrate an awareness of the wider socio-cultural and systemic context in which these difficulties present, including the differing perspectives of service-users and carers, and the different theoretical frameworks that are evident in the multidisciplinary/multiagency setting.
  3. Demonstrate an ability to identify gaps in psychological knowledge in this field and develop ways of advancing psychological knowledge within NHS settings.
  4. Demonstrate an understanding of how established psychotherapeutic approaches for psychosis (e.g. cognitive behavioral therapy for psychosis, cognitive interpersonal therapy and family interventions) are applied to assessment, formulation and treatment, including how these approaches may differ from their application to more common disorders such as anxiety and depression.
  5. Demonstrate competencies in specified models of psychological therapies for psychosis, for example, cognitive-behavioural therapy for psychosis (CBTp) and cognitive interpersonal therapy.
Reading List
Core texts are marked with an asterisk

*Morrison, A. P. (1998). A cognitive analysis of the maintenance of auditory hallucinations: Are voices to schizophrenia what bodily sensations are to panic? Behavioural and Cognitive Psychotherapy, 26, 289-302.

*Morrison, A. P. (2001). The interpretation of intrusions in psychosis: An integrative cognitive approach to hallucinations and delusions. Behavioural and Cognitive Psychotherapy, 29, 257-276.

*Harder, S. (2014). attachment in Schizophrenia┐implications for research, prevention, and Treatment. Schizophrenia bulletin, 40(6), 1189-1193

*Freeman, D., & Garety, P. (2014). Advances in understanding and treating persecutory delusions: a review. Social psychiatry and psychiatric epidemiology, 49(8), 1179-1189.

*Heriot-Maitland, C., & Peters, E. R. (2015). Dimensional approaches to delusional beliefs. In O. Mason, & G. Claridge (Eds.), Schizotypy: new dimensions. (pp. 165-179). Hove: Routledge (available via Emmanuelle Peters' research page at King's College London)

*Birchwood, M., Gilbert, P., Gilbert, J., Trower, P., Meaden, A., Hay, J., ... & Miles, J. N. (2004). Interpersonal and role-related schema influence the relationship with the dominant ┐voice┐in schizophrenia: a comparison of three models. Psychological medicine, 34(08), 1571-1580.

Recommended reading/resources

CBT for psychosis

1. NICE (2014) guidelines for psychosis and schizophrenia in adults: treatment and management
http://www.nice.org.uk/guidance/cg178
(As a minimum, read the introductory section(s) and quick reference guide(s) with particular reference to the service level recommendations (e.g. on access and engagement/early intervention), at risk mental states and psychological interventions sections.)

2. Dunn, G., Fowler, D., Rollinson, R., Freeman, D., Kuipers, E., Smith, B., ... & Bebbington, P. (2012). Effective elements of cognitive behaviour therapy for psychosis: results of a novel type of subgroup analysis based on principal stratification. Psychological medicine, 42(05), 1057-1068.

3. SIGN (2013) Management of Schizophrenia (http://www.sign.ac.uk/pdf/sign131.pdf) and NICE (2013) guidelines for children and young people are also useful (http://publications.nice.org.uk/psychosis-and-schizophrenia-in-children-and-young-people-cg155)

4. You should also familiarise yourself with the competency framework for psychological interventions for psychosis (Pilling and Roth) which is available via the UCL website:
http://www.ucl.ac.uk/clinical-psychology/CORE/competence_mentalillness.html

5. The recent Maudsley Debate (This house believes that CBT for psychosis has been oversold) provides an interesting introduction to many of the key issues in the ongoing CBTp debate
http://www.kcl.ac.uk/ioppn/news/maudsleydebates/index.aspx

6. Morrison, A.P. and Barratt, S (2010) "What are the components of CBT for psychosis? A Delphi Study." Schizophrenia bulletin 36.1: 136-142

Early intervention for psychosis

7. Birchwood, M., Todd, P., & Jackson, C (1998) Early Intervention in Psychosis: the critical-period hypothesis. International Clinical Psychopharmacology, 13 (suppl. 1) S31-S40

8. Morrison AP, French P, Stewart SL, Birchwood M, Fowler D, Gumley AI, Jones PB, Bentall RP, Lewis SW, Murray GK, Patterson P, Brunet K, Conroy J, Parker S, Reilly T, Byrne R, Davies LM, Dunn G, BMJ [BMJ], ISSN: 1756-1833, 2012 Apr 05; Vol. 344, pp. e2233; PMID: 22491790

9. French, P & Morrison, AP (2004) Early Detection and Cognitive Therapy for People at High Risk of Developing Psychosis: A Treatment Approach. Wiley-Blackwell.
van der Gaag, M. et al (2013) CBT for Those at Risk of a First Episode Psychosis: Evidence-based psychotherapy for people with an 'At Risk Mental State'. Routledge

10. Gumley, Andrew, and Matthias Schwannauer (2006) "Staying well after psychosis: A cognitive interpersonal approach to recovery and relapse prevention." Wiley-Blackwell

Assessment workshop

Bell, V., Raballo, A., & Lar°i, F. (2010). Assessment of Hallucinations. In F. Lar°i & A. Aleman (Eds.), Hallucinations: A Practical Guide to Treatment and Management. Oxford: Oxford University Press.

Freeman, D., Bentall, R. P., & Garety, P. A. (Eds.). (2008). Persecutory delusions: Assessment, theory and treatment. Oxford: Oxford University Press.

Greenwood, K. E., Sweeney, A., Williams, S., Garety, P., Kuipers, E., Scott, J., et al. (2010). CHoice of Outcome In Cbt for psychosEs (CHOICE): the development of a new service user-led outcome measure of CBT for psychosis. Schizophr Bull, 36(1), 126-135.

Hutton, P., & Morrison, A. P. (2013). Collaborative empiricism in cognitive therapy for psychosis: A practice guide. Cognitive and Behavioral Practice, 20(4), 429-444.
Morrison, A. P., Renton, J. C., Dunn, H., Williams, S., & Bentall, R. P. (2004). Cognitive Therapy for psychosis. East Essex: Brunner-Routledge.

*Neil, S. T., Kilbride, M., Pitt, L., Welford, M., Nothard, S., Sellwood, W., et al. (2009). The Questionnaire about the Process of Recovery (QPR): A research instrument developed in collaboration with service users. Psychosis, 1, 145-155.

Peters, E. (2011). Assessment for symptoms of psychosis. In R. Hagen, D. Turkington, T. Berge & R. W. Grawe (Eds.), CBT for Psychosis: A Symptom-based Approach (pp. 40-56). Hove: Routledge.

Pitt, L., Kilbride, M., Nothard, S., Welford, M., & Morrison, A. P. (2007). Researching recovery from psychosis: A user-led project. Psychiatric Bulletin, 31, 55-60.

Affect Regulation, Attachment and Recover

Gumley, Andrew, et al. "Emotional recovery and staying well after psychosis: An attachment-based conceptualization." Attachment: New Directions in Psychotherapy and Relational Psychoanalysis 2.2 (2008): 127-148.

Gumley, Andrew, et al., eds. Psychosis and emotion: The role of emotions in understanding psychosis, therapy and recovery. Routledge, 2013.

Additional CBTp resources

Morrison, Anthony P., and Julia C. Renton. "Cognitive therapy for auditory hallucinations: A theory-based approach." Cognitive and Behavioral Practice 8.2 (2001): 147-160

Garrett, M, Stone, D, & Turkington, D. Normalising psychotic symptoms. 2006. Psychology and Psychotherapy: Theory, Research and Practice, 79, 595-610.

Morrison, A.P (2007). Cognitive Therapy for Psychosis: a formulation based approach.

Nelson, H (1997) Cognitive Behavioural Therapy with Schizophrenia: A practice manual.

Fowler, D, Garety, P and Kuipers, L (1995).Cognitive Behavioural Therapy for Psychosis: Theory and Practice

Morrison,A.P, Renton,J, French,P and Bentall, R (2008). Think you┐re Crazy? Think again. A resource book for cognitive therapy for psychosis.

Steel, C., Ed. (2013) CBT for Schizophrenia: Evidence-Based Interventions and Future Directions. John Wiley & Sons, Ltd, Oxford. doi: 10.1002/9781118330029.ch1┐

Negative Symptoms

Griffiths, H and McLeod, H (in submission, book chapter) Negative Symptoms from an Attachment Perspective

Kirkpatrick et al (2006) The NIMH-MATRICS Consensus Statement of Negative Symptoms. Schizophrenia Bulletin, 32, 214-219

Rector, N.A., Beck A.T., Stolar, N. (2005) The negative symptoms of schizophrenia: A cognitive perspective. Canadian Journal of Psychiatry, 5, 247-257

Family Interventions

Magliano, L., Fiorillo, A., Fadden, G., Gair, F., Economou, M., Kallert, T., Schellong, J., Xavier, M., Pereira, M.G., Gonzales, F.T., Palma-Crespo, A., and Maj, M. (2005)
Effectiveness of a psychoeducational intervention for families of patients with schizophrenia: preliminary results of a study funded by the European Commission. World Psychiatry 4:1 45-49

Fadden, G. (1998) Research update: psychoeductional family
interventions. Journal of Family Therapy 20 293-309 [available via ejournals]

Furlong, M., and Leggatt, M. (1996) Reconciling the patient's right to confidentiality and the family's need to know. Australian and New Zealand Journal of Psychiatry 30 614-622

http://www.mwcscot.org.uk/media/52063/Too%20Close%20to%20See%20Mr%20F%20Summary.pdf
Mental Welfare Commission for Scotland (2009) Too close to see: Summary
of our investigation into deficiencies in the care and treatment of Mr F

Patterson, P., Birchwood, M., and Cochrane, R. (2005) Expressed emotion as an adaptation to loss: Prospective study in first-episode psychosis. British Journal of Psychiatry 187 (Suppl.48) 59-64

Kuipers, E., Onwumere, J., and Bebbington, P. (2010) Cognitive model of caregiving in psychosis. The British Journal of Psychiatry 196 259-265
Additional Information
Graduate Attributes and Skills Not entered
KeywordsPsychosis,Psychological Therapies,Cognitive Interpersonal Therapy,Developmental Psychopathology,CBT
Contacts
Course organiserDr Helen Griffiths
Tel: (0131 6)50 3482
Email: Helen.Griffiths@ed.ac.uk
Course secretaryMiss Kirsty Gardner
Tel: (0131 6)50 3889
Email: Kirsty.Gardner@ed.ac.uk
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