Let's Talk 2: A randomised controlled trial to investigate the efficacy of a peer intervention targeted at stigma related mechanisms.
Overview
People who experience psychosis often face stigma and discrimination, which can negatively affect how they consider themselves and their identities. We call this ‘internalising’ stigma. This can cause serious problems with self-esteem, cause depression and anxiety, and withdrawing from others, study or work.
To help people with psychosis feel less troubled by ‘internalised stigma’, mental health researchers in
Manchester adapted an American intervention into a new intervention called ‘Let’s Talk’. We ran a small trial to test this intervention. Let’s Talk involved Peer Support Workers (PSWs), who also have experience of psychosis, meeting with people taking part in the trial (Peers). PSWs and Peers discussed mental health stigma, and how to talk about mental health difficulties with others. Many sessions focused on helping Peers understand how to decide whether they want to discuss their mental health difficulties with others, or not. We found that people were interested in taking part, that most participants offered the intervention attended the sessions, and most participants attended the research assessments.
We want to run a larger trial of Let’s Talk to understand more clearly how it can help improve the personal wellbeing of people who experience psychosis. In a larger trial we can include more participants, and can run more advanced research tests to see what parts of the Let’s Talk approach are most helpful. This would help make Let’s Talk as effective as possible, and it could then be offered in NHS mental health services. A new trial of Let’s Talk would involve inviting 352 people in four UK areas to take part. Everyone who takes part would have a 50% chance of being randomly assigned to receive Let’s Talk with a PSW. The other 50% would receive their usual mental health care only. This is to ensure we are testing the actual effects of the intervention.
Want to take part in this study?
Planned end date
30 Sep 2028 12:14Conditions
PsychosisInclusion Criteria
- Age 16+
- Meet ICD-11 Schizophrenia or other primary psychotic disorders diagnosis (as determined by the participant’s clinical team) or be receiving care for psychosis from Early Intervention Services (EIS) to account for diagnostic uncertainty in the early stages of psychosis.
- Under the care of a secondary or tertiary mental health service at point of referral to ensure provision of care.
- Able to provide written, informed consent (for ethical considerations).
- Willing to engage in a peer support intervention.
- Moderate to severe self-reported disclosure-related distress as determined by scoring > 3 on the disclosure distress screening item.
- Moderate to severe internalised stigma as determined by a score of > = 3 on at least one of the Internalised Stigma domains of the Semi-structured Interview Measure of Stigma.
Exclusion Criteria
- A primary diagnosis of alcohol or substance dependency, where this is clearly the cause of their psychotic symptoms. This does not exclude people who use substances or alcohol, only those with a primary diagnosis. This will be confirmed by participants' care teams.
- A diagnosis of moderate to severe learning disability. This will be confirmed by participants' care teams.
- An ICD-11 diagnosis of organic psychosis. This will be confirmed by participants' care teams.
- Non-English speaking, since the intervention workbook has been adapted for individual delivery in English and is a talking therapy which would require both translation (workbook) and interpreters during the intervention session. Provision for non-English speakers would not be feasible within the scope of this controlled test of intervention efficacy as the intervention workbook has been developed and tested for feasibility in English.
- Immediate risk to self or others. This will be confirmed by participants' care teams.
- Currently receiving structured, individual psychological therapy.