Title: iMAgery focused therapy for PSychosis (iMAPS-2): A feasibility randomised controlled trial
Funder: Department of Health and Social Care

Abstract: Aims Our research aims to improve the current treatments for people with psychosis and schizophrenia. Our main aim is to assess whether it is feasible to conduct a randomised trial to examine the (clinical and cost) effectiveness of an imagery focused psychological therapy in psychosis. The therapy specifically targets distressing &ldquo;mental imagery&rdquo; e.g. &ldquo;pictures in the mind s eye, sounds in the mind s ear&rdquo;, and negative beliefs, frequently reported but infrequently treated. Background Schizophrenia is a severe mental health condition, where individuals hear distressing voices other people cannot hear (hallucinations) and/or have distressing unusual beliefs that others do not share (delusions). They also report negative core beliefs (e.g. &ldquo;I am vulnerable; I am a failure; Others are hostile&rdquo;) and unwanted intrusive mental images (that are in the &ldquo;mind s eye&rdquo; and other senses) which may be maintaining factors for psychotic symptoms. One of the best interventions for psychosis is Cognitive Behavioural Therapy (CBT), which is recommended by the UK National Institute for Health and Care Excellence (NICE). Sadly, CBT for Psychosis has small effect size, and there is a need to refine and improve it. We wish to undertake a feasibility randomised controlled trial of an imagery focused therapy called iMAPS, which targets negative images and negative core beliefs (schemas) Design and methods to be used We will ask 45 patients with psychosis to take part in our study: 30 will have iMAPS and their usual care and the other 15 patients will continue with their usual care. The project will tell us if we may be able to run a definitive randomised controlled clinical trial. Patient and Public Involvement (PPI) Patients have been involved throughout: in helping to design the first studies and the therapy, deciding which measures are useful, review documentation, assist with interpretation of results and support dissemination activities.

Lay abstract: &ldquo;I really do think the therapy helped me. The images don t really occur too much anymore. I don t think about them&hellip;, as much as I did before the therapy. I m putting &ldquo;changing the meaning of memories [imagery therapy]&rdquo;, I m using that for other things that have troubled me in the past.&rdquo; Participant iMAPS-1 Aims Our research aims to improve the current treatments for people with psychosis. We wish to test the feasibility of a talking therapy that specifically targets distressing &ldquo;mental imagery&rdquo; e.g. &ldquo;pictures in the mind s eye, sounds in the mind s ear&rdquo;, and negative beliefs, frequently reported but infrequently treated. Background Psychosis is a mental health condition, where individuals hear distressing voices other people cannot hear and/or have distressing unusual beliefs, which others do not share. They also report negative core beliefs called schema (e.g. &ldquo;I am a failure; others are hostile&rdquo;) and unwanted (intrusive) pictures in the mind s eye &ldquo;mental images&rdquo;. Sadly, current psychological therapies do not work for everyone. We have tested a more specific way of working with negative beliefs and images in psychosis which targets and uses imagery. Methods We will ask 45 people with psychosis to take part: 30 will have iMAPS and usual care and the other 15 their usual care. The project will tell us if we may be able to run a bigger version of the trial. We will only know if the intervention works, when we do the bigger study, but this is an important step. Patient and Public Involvement Patients have been and will be involved in: helping to design studies and the therapy, deciding on measures, helping us highlight the study, interpreting the findings and helping us spread the word. We will tell people about what we find including via practice manuals, workshops and conferences and scientific publications.

Research activity codes: 6.6 PSYCHOLOGICAL AND BEHAVIOURAL
Health categories: MENTAL HEALTH