Assessing the Acceptability and Feasibility of TRUST, a Brief Intervention for Paranoia in Adolescents.
Phase: NA
Conditions: Paranoia
Sponsor: Lucy Jonas

Department of Psychology 
Royal Holloway University of London 
 
Egham, Surrey, TW20 0EX 
www.royalholloway.ac.uk/psychology 
 
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Assessing the acceptability and feasibility of a brief intervention for paranoia in 
adolescents. 
 
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Cover Page 
 
Official Title: Participant Information Sheet for Assessing the Acceptability and Feasibility 
of TRUST, a Brief Intervention for Paranoia in Adolescents. 
NCT number: To be assigned 
Document Date: 22/04/2025 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 

Department of Psychology 
Royal Holloway University of London 
 
Egham, Surrey, TW20 0EX 
www.royalholloway.ac.uk/psychology 
 
Version 2 
11/04/2025 
IRAS 354369 
 
Assessing the acceptability and feasibility of a brief intervention for paranoia in 
adolescents. 
 
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RESEARCH PROTOCOL 
 
Assessing the acceptability and feasibility of a 
brief intervention for paranoia in adolescents. 
 
 
 

Department of Psychology 
Royal Holloway University of London 
 
Egham, Surrey, TW20 0EX 
www.royalholloway.ac.uk/psychology 
 
Version 2 
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IRAS 354369 
 
Assessing the acceptability and feasibility of a brief intervention for paranoia in 
adolescents. 
 
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Contents  
 
1. Research Team and Key Contacts…………………………………………………….………3  
2. Introduction……………………………………………………………………………………….….4  
3. Background…………………………………………………………………………………………..4   
4. Study Objectives…………………………………………………………………………………….6   
5. Study Design and Protocol……………………………………………………………………….7  
6. Study Participants…………………………………………………………………………………..7    
7. Outcome Measures………………………………………………………………………………..9  
8. Data Collection, Source Data and Confidentiality……………………………………….11  
9. Statistical Considerations……………………………………………………………………….11  
10. Data Monitoring and Quality Assurance…………………………………………………….13  
11. Safety Considerations and Adverse Events………………………………………………..13 
12. Peer Review………………………………………………………………………………………….13  
13. Ethical and Regulatory Considerations……………………………………………………..14  
14. Statement of Indemnity…………………………………………………………………………..15  
15. Funding and Resources………………………………………………………………………….15  
16. Publication Policy…………………………………………………………………………………16    
17. References………………………………………………………………………………………….16 
 
 
 

Department of Psychology 
Royal Holloway University of London 
 
Egham, Surrey, TW20 0EX 
www.royalholloway.ac.uk/psychology 
 
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Assessing the acceptability and feasibility of a brief intervention for paranoia in 
adolescents. 
 
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1) RESEARCH TEAM & KEY CONTACTS 
 
Chief Investigator 
 
Name: Miss Lucy Jonas (Doctorate in Psychology 
Student) 
 
Address: Royal Holloway, University of London 
Department of Psychology 
Egham  
Surrey 
 
Email: lucy.jonas.2023@live.rhul.ac.uk 
Telephone: N/A.  
Co-Investigator(s) 
  
Name: Dr Jessica Kingston (Academic Supervisor) 
 
Address: Royal Holloway, University of London,  
Department of Psychology 
Egham 
Surrey 
 
Email: jessica.kingston@rhul.ac.uk 
Telephone: 01784414105 
Co-Investigator(s): 
 
Name: Dr Christopher Taylor (Academic 
Supervisor) 
 
Address: School of Psychology, Interdisciplinary 
Centre of Social Science, 219 Portobello,  
Sheffield 
S1 4DP.  
 
Email: chris.d.j.taylor@sheffield.ac.uk 
Telephone: 0114 222 6517 
Sponsor(s): 
 
Name: Ms Leisha Wickham 
 
 
Address: Orchard Building,  
Royal Holloway, University of London,  
Egham,  
Surrey 
TW20 0EX.  
 
Email: ethics@rhul.ac.uk 
Telephone: 01784414427 
Lead R&D Trust contact(s) 
 
Name: Mr Robert Pleass 
 
Address: Noclor NHS Research Office, JML 
House, 8 Regis Road, Kentish Town 
London 
NW5 3EG 
 
Email: contact.noclor@NHS.net 
 
 
 

Department of Psychology 
Royal Holloway University of London 
 
Egham, Surrey, TW20 0EX 
www.royalholloway.ac.uk/psychology 
 
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Assessing the acceptability and feasibility of a brief intervention for paranoia in 
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2) INTRODUCTION  
Paranoia involves intense fears that others may deliberately intend to cause you harm. This 
fear of being under threat and unable to trust others can cause significant distress and makes 
it harder to complete everyday tasks. Paranoia is common in adolescence, occurring in 
psychosis and other mental health disorders. However, there are currently no specific 
treatment plans to support adolescents with paranoia. This study aims to address this gap 
by delivering a new intervention designed to help young people (aged 16-18) who are 
experiencing paranoia and waiting for mental health care.  
 
Previous research has shown that interventions using values-based approaches (what 
matters most to a person) and mental imagery (visualising scenarios to change how we think 
or feel) can help reduce paranoia in adults and general adolescent populations. This study 
combines these approaches, which have already proven effective, into a six-week 
intervention for adolescents on a Child and Adolescent Mental Health (CAMHS) waiting list.  
The participants will complete self-report questionnaires measuring paranoia, social 
functioning, mental imagery and beliefs about themselves and others before starting the 
study, after the intervention and again one month later. During the intervention, participants 
will have six weekly therapy sessions and complete shorter weekly assessments to track 
changes in paranoia. At the end, we will ask participants about the acceptability of the 
intervention. 
 
We want to find out how practical the new intervention is to deliver and complete, and how 
well adolescents will receive and engage with the treatment. We will also assess whether the 
intervention reduces paranoid thoughts and improve overall well-being. We hypothesise that 
(1) the intervention will be acceptable and feasible for use with young people who experience 
paranoia, (2) it will help reduce paranoia and improve their daily functioning and (3) these 
improvements will be maintained at one-month follow-up. 
 
3) BACKGROUND 
Adolescence is a vulnerable period for the development of mental health problems. Their 
social world becomes more unpredictable and uncertain, so they can be more vigilant of the 
intentions of others (Blakemore et al., 2018). Therefore, paranoia - the exaggerated fears that 
others may intend to cause you harm - is a common experience among adolescents 
(Freeman & Garety, 2014; Freeman 2011). 20-30% report weekly fears and for some will 
develop into persecutory delusions (Dominguez et al., 2014). Paranoia is transdiagnostic, 
meaning it occurs across a range of disorders (Freeman et al., 2019a). This means it is 
reported by help seeking individuals with a range of non psychotic mental health disorders 
(van Os & Reininghaus, 2016). Recent evidence suggests paranoia is a common presentation 

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Egham, Surrey, TW20 0EX 
www.royalholloway.ac.uk/psychology 
 
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in those attending child and adolescent mental health services (Bird et al., 2021). 
Approximately 35% of those seeking mental health care show clinical levels of paranoia (Bird, 
2022). Other studies show that 1 in 5 adolescents report experiencing weekly paranoid 
thoughts (Kingston & Parker, 2022).   
 
Research shows how severely paranoia can affect an adolescent's life (Bird et al., 2019). It 
can make it difficult for them to interact with others, form relationships, and engage in 
everyday activities, often leading to isolation and distress. If untreated, paranoia can worsen 
over time, sometimes developing into more severe issues like persecutory delusions (where 
a person believes others are deliberately trying to harm them) or hallucinations (where a 
person hears or sees things that are not there) (Bird et al., 2019; Dominguez et al., 2011). 
Early intervention is key to preventing these symptoms from becoming more persistent and 
serious. 
 
Despite its prevalence and impact, no specific clinical guidelines exist to address paranoia 
in adolescents seeking mental health support. This represents a significant gap in care, 
leaving many young people without support. Current models to address paranoia have 
focused almost exclusively on research from adults. In adulthood, interventions like values-
based approaches and mental imagery have shown promise in reducing paranoia (Parker & 
Kingston, 2021; Taylor et al., 2020). These interventions work by addressing underlying 
cognitive processes such as negative self and other beliefs, distressing mental images, and 
a lack of value-directed behaviour, which are known to maintain paranoia (Garety & Freeman, 
2013; Kingston & Ellet, 2014). 
 
This research has the potential to address a critical gap in the mental health care of 
adolescents by providing: 
(A). The research will help determine how to deliver effective, brief treatments for 
paranoia, informing clinical practices and contributing to future treatment guidelines for 
adolescents. 
(B)  Clinical approaches to paranoia is likely to require a tailored approach that 
acknowledges the unique life-stage issues associated with adolescence (McGorry, 2007). 
Evidence on age-specific needs and preferences, promoting greater engagement and 
effectiveness of interventions for adolescents. 
(C) A stronger theoretical foundation for understanding the role of diminished value-
directed behaviour and distressing mental imagery in the maintenance of paranoia. 
 
4) STUDY OBJECTIVES 
4.1 Primary Question/Objective:  

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The principle aim of this research is to determine whether it is feasible and acceptable to 
deliver a six-session intervention to adolescents who are on a Child and Adolescent Mental 
Health Service (CAMHS) waiting list and distressed by paranoid worries.  
 
4.2 Secondary Question/Objective:  
This study aims to explore whether the intervention provides any preliminary clinical 
benefits for young people experiencing paranoia. Specifically, we will assess whether the 
intervention helps to: 
• 
Reduce distressing paranoid thoughts (using the Revised Green Paranoid 
Thoughts Scale) 
• 
Improve daily functioning in areas like school, social life, and family 
relationships (using the Work and Social Adjustment Scale for Youth) 
• 
Change negative beliefs about oneself and others (using the Brief Core Schema 
Scale) 
• 
Reduce distressing mental imagery associated with paranoia (assessed by 
Negative Mental Imagery Scale) 
• 
Improve Value Based Action (assessed by the CompACT-Y).  
 
5) STUDY DESIGN AND PROTOCOLS 
5.1 Participants 
Young people aged 16–18 seeking psychological therapy at Westminster Child and 
Adolescent Mental Health Service (CAMHS) will be invited to participate. A total of 5–8 
participants will be recruited, based on the effect replication required for this design and a 
review of previous single-case experimental design (SCED) studies (e.g., Taylor et al., 2020). 
 
5.2 Study Intervention and/or Procedures 
Before starting the intervention, participants will be randomised to different baseline lengths 
(2, 3, or 4 weeks) via an online randomisation software (Sealed Envelope). During the 
baseline phase, participants will not receive the intervention but will complete up to four 
assessments to measure their symptoms and establish a stable starting point.  
 
Participants assigned to a 2-week baseline will complete three assessments (at the start 
,middle and end). Those assigned to a 3-week baseline will complete three assessments 
(weekly). Participants assigned to a 4-week baseline will complete four assessments (at the 
start, week 1, week 2, and end). The maximum time that it would take participants to 
complete take a participant to complete questionnaires in one sitting would be 
approximately 10 minutes. The questionnaires will be completed on Qualtrics. The measures 
vary in length, but they all consist of rating statements on a Likert scale. The initial 

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assessment and follow-up questionnaires measure different constructs, including paranoia, 
functioning, negative self and other beliefs and mental imagery. 
 
After the baseline phase, participants will attend six one-to-one sessions, with each session 
having a duration of 60 minutes. Participants will also complete one brief weekly 
questionnaire (RGPTS- Part B) and two single item measures before their session to monitor 
their symptoms and experiences of paranoia during the intervention. 
 
Session 1: Assessment, formulation and psychoeducation (teaching) about paranoia.  
Session 2: Identifying personal values and setting goals based on those values. 
Session 3-5: Using mental imagery techniques to challenge negative beliefs about 
themselves and others. 
Session 6: Bringing it all together (e.g., reviewing sessions, plan for implementing strategies, 
discussing mid and longer term valued goals). 
 
One month after the intervention ends, participants will meet with the CI again and complete 
the four initial assessment questionnaires (approximately 15 minutes) to measure any lasting 
effects of the therapy. 
 
The appointments will take place at an NHS Psychological Services base though there is the 
option for the study to take place on MS Teams if a preference for video therapy is expressed 
or if required.  
 
6) STUDY PARTICIPANTS 
6.1 Inclusion Criteria 
• 
Aged 16-18 
• 
Seeking help from a Child and Adolescent Mental Health Service (CAMHS) 
• 
A score ≥ 11 on the R-GPTS (Scale B) 
• 
Sufficient understanding of English 
• 
Capacity to consent, as assessed during the initial interview 
• 
Wanting support with paranoia 
• 
Low- moderate mental health risks (emotional difficulties that impact functioning, 
but no immediate risk to safety e.g., no suicidal intent).  
 
6.2 Exclusion Criteria  
• 
Severe comorbid diagnoses apparent at the initial assessment (e.g., a primary 
alcohol or substance dependence issue) 

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• 
The presence of a developmental disability or cognitive impairment that would 
interfere with participation.  
• 
Concurrent participation in another psychological therapy 
• 
High levels of current risk (e.g., significant and immediate concerns about the young 
person’s safety, such as suicidal intent) 
 
6.3. Recruitment  
Potential participants will be identified through two main routes: 
 
(A) New Referrals: Westminster CAMHS holds a weekly intake meeting where newly 
referred cases are reviewed. Professionals in attendance will identify young people who may 
be suitable for the study and notify the clinician conducting their Initial Assessment (IA). If, 
at the end of the IA, the young person is still deemed appropriate for the study, the clinician 
will introduce the study and ask the young person if they consent to their contact details 
being shared with the Chief Investigator (CI). If the young person expresses interest, verbal 
consent will be obtained for their contact details to be shared with the Chief Investigator (CI). 
The CI will then invite them to an initial meeting, talk them through the study, ask them to 
complete the screening questionnaire and assess eligibility, and then invite them to take part 
and gain consent (see below).  
 
(B) Existing Waiting List: An administrator or Assistant Psychologist at Westminster 
CAMHS will also review the waiting list to identify young people who have already had their 
IA and are awaiting treatment. The young person’s case manager or an assistant psychologist 
will contact them to discuss potential participation in the study. If the young person agrees, 
their contact details will be passed to the CI for further discussion and formal consent. 
 
Potential participants may become aware of the study through posters displayed in the 
Westminster CAMHS reception area. These posters will provide basic information about the 
study, including its purpose, eligibility criteria, and how to express interest. 
 
To enhance recruitment, information about the study will be shared through multiple 
channels, such as the Monthly Business Meetings at Westminster CAMHS, Weekly sub-team 
meetings and Posters in the reception area, where young people attending their IA may see 
the study and express interest. 
 
6.4 Randomisation  
Participants will be randomised to different baseline lengths (2, 3, 4) weekly assessment via 
an online randomisation software (Sealed Envelope).  

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6.5 Participants who withdraw consent [or lose capacity to consent]:  
Participants can withdraw consent at any time without giving any reason, as participation in 
the research is voluntary, without their care or legal rights being affected. Should the 
participant lose capacity to consent during the study then they will be withdrawn but any data 
already collected will be retained and used in the study. This will be outlined on the consent 
form and information sheet.  
 
If there are concerns regarding mental capacity by either the research team or the 
participants' clinical care team then the clinical care team will undertake a Mental Capacity 
Act assessment. This would be completed and recorded in clinical records per their standard 
local procedure. The results of this would be passed to the research team via email.  
 
7) OUTCOME MEASURES  
 
The primary outcome for the study is feasibility of the intervention and as such, this will 
measure using the following metrics: 
 
Regarding the number of: 
• 
Individuals approached regarding the study 
• 
Individuals recruited for the study 
• 
Sessions attended 
• 
Individuals who drop-out and at which point in the programme 
 
Acceptability will be measured using the results from the Client Satisfaction Questionnaire 
(CSQ; Larsen et al., 1979). This is completed after session 6 of the intervention.  
Any preliminary potential clinical benefits will be determined using the following outcome 
measures; changes in outcome measure scores from first baseline to end of therapy 
assessment will be calculated. The suitability of outcome measures will also be measured 
(determined by % completion).  
• 
Paranoia: The Revised Green Paranoid Thoughts Scale (R-GPTS; Freeman et al., 
2019). 
• 
Functioning: The Work and Social Adjustment Scale for Youth (WSAS-Y; Jassi et al., 
2020)  
• 
Negative self and Other Beliefs: The Brief Core Schema Scales (BCSS; Fowler et al., 
2006)  
• 
Mental Imagery: The Negative Mental Imagery Scale (Oaie et al., 2024)  
• 
Values: Compact (ACT-Y) – (Morey et al., 2024) 
 

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8) DATA COLLECTION, SOURCE DATA AND CONFIDENTIALITY  
The research team will not have access to personal identifiable data prior to verbal consent 
from the potential participant. The researchers will liase with the mental health care team via 
secure NHS email and details of contact information will only be shared in the NHS site. The 
use of personal contact details will be limited to contacting participants once they had met 
inclusion criteria and expressed interest in participating in the study; this would be to arrange 
screening and appointments. Data will be pseudonymised during the course of the research. 
An ID will be assigned to each participant to ensure that outcome measure data can be linked 
together throughout the process of the research. Pseudonymisation is used to protect 
participant confidentiality because only those with access to the key are able to link the data 
to the individual; access to the key will be strictly limited to the chief investigator and their 
supervisors.  
 
Following Royal Holloway, University of London Standard Operating Procedures pertaining to 
‘taking recordings of participants for research projects’ and ‘information security 
classification, ownership and secure information handling’, personal data in physical form 
will not be left unattended and files will be transferred to the secure NHS and university 
servers as soon as possible. Audio and/or video recordings of sessions will be stored in a 
secure cloud platform which can be accessed by the chief investigator and co-investigators 
on private computers in secure environments. Video recordings provide additional detail in 
regard to non-verbal cues for supervision; audio recordings will be an alternative option. 
Audio and/or video recordings will be destroyed after a three-month period. The recordings is 
for checking intervention protocol adherence as opposed to gathering any data for the 
research. 
 
Study data and material may be looked at by individuals from the University of Manchester, 
from regulatory authorities or from the NHS Trust, for monitoring and auditing purposes, and 
this may well include access to personal information. 
 
The data generated will be analysed in a private residence of, and by, the Chief Investigator. 
Data transferred will be completely anonymised on an NHS computer prior to transfer. Data 
will not be transferred outside of the UK. 
 
9) STATISTICAL CONSIDERATIONS  
9.1 Statistical Analysis  

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A statistical review was not deemed necessary for this research study as only frequencies 
and associations will be assessed. 
Descriptive statistics will be used to evaluate the characteristics of the sample population.  
Descriptive statistics will be utilised to evaluate the feasibility of the intervention. Participant 
recruitment, attendance and retention will be described using frequency statistics and 
percentages.  
The feasibility and acceptability criteria follow a three-level ‘traffic light’ approach (Avery et 
al., 2017) to determine whether a future trial is feasible with the current design (GREEN), 
feasible with modifications (AMBER), or not feasible due to significant issues (RED). Our 
target sample size is 5 to 8 participants. 
1. Recruitment: 
o 
GREEN: 5 or more participants recruited 
o 
AMBER: 3 to 4 participants recruited 
o 
RED: 2 or fewer participants recruited 
2. Retention: 
o 
GREEN: 5 or more participants complete the end-of-therapy assessment 
o 
AMBER: 3 to 4 participants complete the end-of-therapy assessment 
o 
RED: 2 or fewer participants complete the end-of-therapy assessment 
3. Adherence: 
o 
GREEN: 5 or more participants attend at least 3 therapy sessions 
o 
AMBER: 3 to 4 participants attend at least 3 therapy sessions 
o 
RED: 2 or fewer participants attend at least 3 therapy sessions 
Therapy acceptability will also be evaluated through participant feedback using a therapy 
process feedback questionnaire and an adverse effects questionnaire, administered upon 
therapy completion or withdrawal. 
We will proceed with to a full trial if all criteria are classified as GREEN. If any criteria are 
AMBER, we will consider adjustments to the intervention and study design to address the 

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issues and reassess feasibility. If that is possible, we will progress to a full trial. If any criteria 
are RED, we will not progress unless substantial amendments can make further testing 
feasible. 
Outcome measure scores pre- and post-intervention will be analysed using SPSS statistical 
software to determine effect sizes and descriptive statistics (M, SD, % change) will also be 
reported. Individual graphs will be plotted for each participant to visually display the changes 
in outcome measures over the course of the study. Reliable (Morley & Dowzer., 2014) and 
clinically significant change (Jacobson & Truax., 1992) will be calculated using the Leeds 
Reliable Change Index calculator from baseline to end of treatment. 
9.2 Sample Size 
As the primary objective of the study is to complete a single case experimental design to 
determine feasibility of an intervention, a power calculation is not required, rather the target 
is based on consideration of logistics, resources and time per guidance from the Pilot and 
Feasibility 
Studies 
Working 
Group 
(https://pilotandfeasibilitystudies.qmul.ac.uk/resources/).  
 
10)  DATA MONITORING AND QUALITY ASSURANCE  
The study will be subject to the audit and monitoring regime of Royal Holloway, University of 
London.  
 
Due to the research study being a proof of concept and feasibility single case experimental 
designs, we will not be using a Data Monitoring Committee. The Chief Investigator is a trainee 
clinical psychologist and the co-investigators are qualified clinical psychologists, along with 
the research and intervention taking place in an NHS secondary care setting, it is anticipated 
that the setting of the research, training and experience of the researchers will allow for safety 
to be monitored closely. Clinical supervision will be utilised regularly by the Chief Investigator 
and other members of the participant's care team (Care Coordinators in secondary care 
services, General Practitioner) who are responsible for risk will be appraised of any concerns 
regarding distress or safety. There are detailed safeguarding procedures in place.  
 
11)  SAFETY CONSIDERATIONS AND ADVERSE EVENTS  
As with all psychological interventions, there is the potential that young people will discuss 
things that they find upsetting (e.g., paranoia related worries). To address this, sessions will 

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take place in a safe and confidential NHS psychology service, where additional support can 
be accessed if needed. Following safeguarding procedures of the service will guide the 
researcher in managing adverse events or disclosures that occur if sessions are online. 
Participants will also receive written information on how to contact crisis services between 
sessions if more regular support is needed. 
 
12) PEER REVIEW  
The research was written into a detailed proposal document and reviewed by the Royal 
Holloway University of London Clinical Psychology Doctorate Course research sub-
committee. The proposal included information on the project summary, background and 
aims, plan of investigation (including sample, setting, measures, design, analysis), ethical 
considerations, service user involvement, practical considerations and dissemination. The 
criteria used by the committee included validity, feasibility and methodological soundness 
of the project.  
 
The first review of the full proposal took place on 18/10/2024 and feedback was provided to 
the trainee clinical psychologist by the committee. Their comments were answered and 
conditions responded to on 13/25/2025. The proposal was approved on 10/01/2025. 
 
13) ETHICAL and REGULATORY CONSIDERSATIONS  
13.1 Approvals  
NHS Research Ethics Committee and HRA approval will be obtained from Health and Social 
Care Research Ethics Committee REC A (HSC REC A) before commencing research. 
 
The study will be conducted in full conformance with all relevant legal requirements and the 
principles of the Declaration of Helsinki, Good Clinical Practice (GCP) and the UK Policy 
Framework for Health and Social Care Research 2017.  
 
13.2 Risks  
Talking about paranoia and mental health may bring up difficult emotions or memories for 
participants. In some cases, the intervention could make paranoid thoughts worse, increase 
distress, or lead to more mistrust. To manage this, the Chief Investigator (CI) will regularly 
check for signs of distress or worsening paranoia. Participants safety will be prioritised when 
carrying out the therapy. If they become distressed, they will be invited to take a break, and 
made aware that the session can be discontinued. If needed, the CI will work with their 
supervisors to decide if it’s safe to continue sessions. A distress protocol will be in place to 
guide the CI in handling any adverse events. The sessions will take place in a safe, 
confidential CAMHS setting with support available if necessary. 
 

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Participants might worry about being labelled with paranoia, especially if they have 
previously been told their experiences were more related to common adolescent worries, like 
social anxiety. This could lead to feelings of shame. To reduce this risk, only participants with 
significant paranoia will be included, using a specific assessment tool (RGPTS Scale B). The 
study will take a supportive approach, reassuring participants that their participation is 
voluntary and that any symptoms will be explored in a non-judgmental way. 
 
The study requires a screening call, six sessions, and a one-month follow up, which may feel 
like a burden for some participants, especially if they are struggling with low motivation. The 
CI will work to schedule sessions at convenient times and will send reminders for 
appointments and questionnaires. The weekly questionnaires will be brief (about 10-15 
minutes), and the CI will keep the process as easy as possible for participants to reduce their 
burden.  
 
Previous research suggests that adults and a general population of adolescents have already 
benefited from the components of this research. However, we do not yet know whether the 
outcomes will be the same for this client group. This is therefore a risk. However, there is no 
evidence to suggest that any harm will come through participation. Moreover, as this is a new 
intervention, there may be unexpected outcomes, such as lack of interest or difficulty 
engaging with the content. The CI will regularly assess participant feedback and the 
effectiveness of the intervention, adjusting as needed to ensure the participant’s well-being. 
 
Participants may be concerned about sharing personal information with the CI as they are 
not part of their direct care team. To address this, the researcher will clearly explain that any 
information shared will remain confidential and only be used for the study. Participants will 
also be reassured that their personal information will not be shared with anyone outside the 
research team unless required by law or safety concern. Participants will be made aware of 
the risk of confidentiality being broken, if there is concern about risk to themselves or others. 
The benefit of this is that the participants and those around them are kept safe. If this disturbs 
the therapeutic relationship, steps will be taken for trust and rapport to rebuild, with 
assistance from supervisors. 
 
14) STATEMENT OF INDEMNITY  
The University has insurance available in respect of research involving human subjects that 
provides cover for legal liabilities arising from its actions or those of its staff or supervised 
students.  The University also has insurance available that provides compensation for non-

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Egham, Surrey, TW20 0EX 
www.royalholloway.ac.uk/psychology 
 
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negligent harm to research subjects occasioned in circumstances that are under the control 
of the University. 
 
15) FUNDING and RESOURCES 
The study has not received any external funding. Royal Holloway, University of London 
Doctorate in Clinical Psychology programme provides a small budget, which will be used to 
work with Experts by Experience (EbEs) for dissemination of results.  
 
16) PUBLICATION POLICY  
The findings from the study will form the basis of part of a doctoral thesis on the Doctorate in 
Clinical Psychology at Royal Holloway. The findings from the study will be disseminated via 
social media, a lay summary will be provided to participants and summaries will be provided 
to the care service from which participants were recruited. The researchers also aim to 
disseminate the results of the research through peer-reviewed scientific journals and 
conference presentation. 
 
 
17) REFERENCES  
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Department of Psychology 
Royal Holloway University of London 
 
Egham, Surrey, TW20 0EX 
www.royalholloway.ac.uk/psychology 
 
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Department of Psychology 
Royal Holloway University of London 
 
Egham, Surrey, TW20 0EX 
www.royalholloway.ac.uk/psychology 
 
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