A Whole System Effort: Implementing Narrative Exposure Therapy in Early Intervention for Psychosis Services

Area of Science:

• Psychiatry
• Clinical Psychology
• Trauma Studies

Background:

• Post-traumatic stress disorder (PTSD) and psychosis can co-occur as responses to trauma.
• Trauma interventions for PTSD in psychosis are effective but poorly implemented in Early Intervention for Psychosis (EIP) services.
• Barriers include a lack of adapted protocols and complex training for trauma interventions.

Purpose of the Study:

• To co-produce a "NET in EIP" delivery manual for a feasibility trial.
• To involve key stakeholders in adapting Narrative Exposure Therapy (NET) for psychosis services.
• To address implementation challenges of trauma-focused interventions in EIP settings.

Main Methods:

• Preliminary Patient and Public Involvement (PPI) work was conducted.
• Stakeholders included individuals with psychosis who received NET, carers, NET therapists, and EIP multidisciplinary team members.
• Co-production of a NET delivery manual for EIP settings.

Main Results:

• Stakeholder recommendations for NET implementation in EIP settings were gathered.
• Key recommendations include clear communication of rationale and expectations, considering the individual within their context, close monitoring during therapy, and a whole-system approach for support.
• The co-produced manual aims to facilitate NET delivery in EIP.

Conclusions:

• Adapting and implementing trauma interventions like NET in EIP services requires careful planning and stakeholder collaboration.
• A whole-system approach and clear communication are crucial for successful integration of NET.
• Further research through a feasibility RCT is planned to evaluate the NET in EIP manual.