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Psychological Interventions Clinic for Outpatients with Psychosis (PICuP)

How our service can help you

Our service offers a range of evidence based psychological therapies including: Cognitive Behavioural Therapy (CBT), Trauma-focused CBT (Tf-CBT), Eye-Movement Desensitisation Reprocessing (EMDR) and Family Interventions (FI) for people with distressing positive symptoms of psychosis such as unusual distressing beliefs, worries about others causing harm, or anomalous experiences such as hearing voices, seeing visions or experiencing a felt presence. We also see people with bipolar disorder who have also had psychosis experiences and those with a history of psychosis whose main difficulties are secondary emotional problems. When capacity allows, clients may be invited to attend psychological therapy groups or psychoeducational workshops while they are on the waiting list to receive individual therapy or alongside their therapy. We have a Friends & Family service that offers support for people whose loved ones have experiences of psychosis and are current clients in PICuP. 

 Our service is psychology-led, headed by international, clinical and academic experts. PICuP was one of the two national demonstration sites for the Improving Access to Psychological Therapies for Severe Mental Illness (IAPT for SMI) project which aimed to increase access to psychological therapies for psychosis, bipolar disorder and personality disorders. PICuP has also led the recent NIHR-funded STAR (Study of Trauma And Recovery) trial. The STAR Trial is a multi-site randomised controlled trial investigating the effectiveness of trauma focused CBT for people experiencing PTSD and co-morbid psychosis. 


We strive to:

  • treat people with dignity and view our service users as experts in their own experiences
  • place no pressure on people to change their view of the world and always work collaboratively with them towards achieving their goals
  • include families, carers and other mental health professionals involved in the person’s care, if the patient wishes to
  • disseminate knowledge and skills to other mental health professionals through training and supervision, both in the UK and overseas
  • work towards improved quality of life for people with psychosis through clinical research and audits
  • aim to increase access to psychological therapies for psychosis and bipolar disorder

  • Service Borough Covers: National (Adult services) Treatment type: Outpatient

  • Contact the service

    Site Location: Maudsley Hospital Email: picup@slam.nhs.uk Phone Number: 020 3228 3524 or 020 3228 5278
  • Disabled Access:

    Yes
  • Address: Middle House
    Ground Floor
    Maudsley Hospital
    Denmark Hill,
    London,
    SE5 8AZ
  • Business Hours/Visiting Hours:

    9am - 5pm

    • Other essential information

  • Conditions: Bipolar disorder, Post-traumatic stress disorder (PTSD), Psychosis

Referrals

Download and complete the  Referral Form

You can email the referral form to picup@slam.nhs.uk or slm-tr.picup@nhs.net. You can also make a referral over the phone on 020 3228 3524.

If you would like to discuss a referral or would like any more information please contact:

Assistant psychologists on 020 3228 3524 or email picup@slam.nhs.uk

Other resources

Interventions

  • Evidence-based Cognitive Behaviour Therapy (CBT): We offer people empirically-validated CBT, consisting of weekly or fortnightly individual, one-hour sessions for a period of six months. CBT works in the present and is based on the assumption that unpleasant emotions are closely linked to certain thoughts or beliefs someone has about themselves, like “I’m worthless”. These thoughts can lead to unhelpful behaviours that maintain the problem and create vicious cycles. Therapy involves identifying these distressing thoughts and behaviours, gradually attempting to understand them, test them out and hopefully change them. Therapy also involves changing unhelpful behaviours and trying out new coping skills for dealing with distressing experiences, like hearing voices
  • Trauma-focused interventions: Research has found there are high rates of childhood and adult trauma within the population of people with psychosis. Furthermore, the experience of psychosis can be traumatic for many people. Such experiences can lead to the development of post-traumatic stress disorder (PTSD). Interventions are provided for people with active symptoms of psychosis who also have PTSD. PICuP has specialist expertise in treating PTSD in psychosis using trauma-focused CBT , Eye movement desensitization and reprocessing ( EMDR ) and Narrative Exposure Therapy (NET). Individual therapy sessions last between 60 and 90 minutes and are held weekly or fortnightly for a period of nine to 12 months. The therapy aims to promote understanding, reduce symptoms and lessen the distress .
  • Groups: When capacity allows, clients may be invited to attend psychological therapy groups or psychoeducational workshops while they are on the waiting list to receive individual therapy or alongside their therapy . The main aims of the se group interventions are for people to gain a better understanding of the CBT model, to learn strategies for coping and self-management of their symptoms, develop the ability to self-soothe and be self-compassionate, and to gain support from others with similar problems. The format is a mixture of information giving, group discussion and worked exercises .  
  • Cognitive Behavioural Based Family Intervention: The intervention is designed to help those with psychosis and their families improve how they cope, problem-solve specific difficulties, manage the emotional impact of psychosis on family members, reduce stress, improve support networks and address issues of relapse prevention. Therapy sessions are one-hour long and clients and their carers are usually seen together on a fortnightly basis for 10 sessions, over a period of three months to one year. Therapy is delivered by two trained therapists with expertise in family intervention. Sessions are offered at the clinic or the person’s home, depending on the family’s preferences and the availability of staff.
  • Friends and Family Support: We offer support for people whose loved ones have experiences of psychosis and are current clients in PICuP. We offer 6 weekly sessions (in person or online) and interventions are informed by research on family and friends of those affected by psychosis. Sessions provide a space to share your experiences and wellbeing, learn about psychosis/bipolar disorder, and gain relapse and crisis support.     

Eligibility criteria

Eligability:

  • 18 years and over
  • Distressing positive symptoms of psychosis such as unusual distressing beliefs, worries about others causing harm, or anomalous experiences such as hearing voices, seeing visions or experiencing a felt presence.
  • People with bipolar disorder who have also had psychosis experiences.
  • Those with a history of psychosis whose main difficulties are secondary emotional problems.
  • Support from the referring community mental health team or GP.
  • Presence of distress and motivation to attend therapy.
  • No severe or primary drug or alcohol problem, excluding cannabis.
  • No current risk of violence.
  • No moderate or severe learning disability 

Outcomes

  • Reduction in distressing psychotic symptoms
  • Reductions in hospital admissions
  • Cost-effectiveness
  • Enhanced coping and self-management of symptoms
  • Improved mood
  • Improved quality of life
  • Reduction in post-traumatic stress symptoms
  • High satisfaction with therapy
  • Achievement of individual recovery goals
  • Peters E., Crombie T., Agbedjro D., Johns L., Stahl D., Greenwood K., Keen N., Onwumere J., Hunter E., Smith L., Kuipers E. (2015) The long-term effectiveness of Cognitive Behaviour Therapy for Psychosis within a routine psychological therapies service. Frontiers in Psychology, doi:10.3389/fpsyg.2015.01658

Care Options

Care option: Assessment and treatment

Code: Not applicable

Unit: Per assessment / Per session

Description: Cognitive behaviour therapy (CBT) for people with distressing, positive symptoms of psychosis (including bipolar disorder), or secondary emotional problems with a history of psychosis. There are four assessment sessions, which take place at referral, prior to starting therapy, end of therapy and at six-month follow-up, using a range of standardised psychological outcome measures.  

Therapy sessions last approximately one hour and people are seen weekly or fortnightly for approximately six months. Therapy is delivered by trained therapists specialising in CBT for psychosis and bipolar disorder, as well as their trainees. 
 


Care option: Therapeutic groups

Code: Not applicable

Unit: Per person / Per session

Description: Psychological Interventions Clinic for outpatients with Psychosis (PICuP)

Groups involve six to eight weekly sessions with two therapists, lasting 60 to 90 minutes, in a group of four to six people. Sessions focus on a psychological understanding of problems and techniques to improve wellbeing, like sleep hygiene, stress and anxiety management, and developing self-compassion. 
 


Care option: Family intervention

Code: Not applicable

Unit: Clinic: per session, office hours / Home: per session, office hours

Description: These sessions are for people with psychosis and their carers, to help them cope with problems and stressors together. Sessions last approximately one hour and families are seen fortnightly for three months to one year. Sessions are offered either in the clinic or in the person’s home. 
 


Care option: Trauma and psychosis

Code: Not applicable

Unit: Per session

Description: Individual sessions, suitable for people with active psychotic symptoms who are also suffering from post-traumatic stress disorder or another condition of trauma. 

 

Care option: Groups  

Description: Therapeutic Groups and Psychoeducational Workshops support people to gain a better understanding of the CBT model, to learn strategies for coping and self-management of their symptoms, develop the ability to self-soothe and be self-compassionate, and to gain support from others with similar problems.  

More info

Peer support and involvement

This includes:  

  • Recruiting and training volunteers who have had recent experience of receiving therapy at PICuP to support people who may be anxious about travelling alone to attend therapy by accompanying them to their sessions 
  • Peer supporters are available to share their experience of therapy at PICuP with anyone who may be anxious or curious about what is involved in therapy 
  • Peer supporters also facilitate group activities 

Please contact catherine.lankester@slam.nhs.uk  for more information. 


Training and consultancy

We provide a range of continuous professional development packages, both in the UK and overseas. We also offer workshops and customised training packages for mental health professionals working with people with psychosis and bipolar disorder who require further training in general CBT as well as CBT for psychosis, trauma-informed CBT for psychosis, bipolar disorder, and family intervention.

These include: 

  • In-house group supervision 
  • Outreach supervision groups 
  • Full-day and half-day workshops 
  • Outreach customised training packages 

Group supervision is aimed at therapists already trained in CBT or family intervention who want to develop specialist skills in CBT or family intervention for psychosis. Therapists can work with some of our clients (in our daytime or evening clinics) and receive free fortnightly supervision at our clinic. We also run outreach groups for supervision of therapists’ own clients, which cost £400. Supervision will be held at the clinicians’ team base or can be run through video-conferencing facilities for therapists working outside of London or overseas.  


We also offer workshops and customised training packages for mental health professionals working with people with psychosis and bipolar disorder who require further training in general CBT as well as CBT and trauma-focused CBT for psychosis, bipolar disorder, and family intervention at a negotiated fee. 
 
For clinicians requiring more formalised training, please see Institute of Psychiatry, Psychology and Neuroscience graduate and postgraduate courses (certificate and diploma). 

Please contact  rumina.taylor@slam.nhs.uk  for more information.

Our experts

Prof Emmanuelle Peters: Read more

Dr Nadine Keen: Read more

Dr Harriet Mellotte: Read more

Dr Fergus Kane: Read more

Dr Rumina Taylor: Read more

Dr Amy Hardy: Read more

Christopher Shoulder: Read more

Dr Rebecca Kelly: Read more

Dr Sarah-Jane Grice: Read more

Dr Andrew Watson Read more

Dr Catherine Lankester Read more

Dr Claire Hackford Read more

Dr Joe Kibble Read more

 

Training courses

event picture

Due to growing demand the PICuP Clinic, a multi-award winning service, are delighted to be offering a 5-day training course on delivering evidence-based trauma-focussed cognitive behavioural therapy for psychosis (TF-CBTp), based on the recently completed STAR Trial. During this training course you will learn about the ground breaking findings from the trial while also developing skills in how to deliver TF-CBTp.

For further information and to book your place visit here: https://www.eventbrite.co.uk/o/picup-training-120668773748    

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