Dr Lyn Ellett

2022

Background

Research is developing in the benefit of mindfulness-based interventions (MBI) for people with psychosis. However, it is yet to evaluate the clinical benefit of delivering MBI groups online. This study is the first to evaluate a group‐based mindfulness intervention for people hearing distressing voices that is delivered entirely online and in routine clinical practice. This study aimed to examine engagement, clinical outcomes, participant experience and therapeutic process of delivering therapy groups online in routine clinical practice.

Methods

The study used an uncontrolled pre-post design to examine engagement, therapeutic benefits, and group process in a 12-session online mindfulness group. The project was registered with the NHS and benefits included depression, anxiety, beliefs about voices, for individuals with a schizophrenia spectrum diagnosis with current distressing voices. Qualitative data on participant experience of online group therapy were analysed using Thematic Analysis.

Results 

 81% of participants completed one of three consecutively run therapy groups. For completers there were significant reductions pre-post in depression, anxiety, beliefs about voices and voice-related negative affect, with medium to large effect sizes. There were individuals showing reliable and clinically significant improvements in each clinical outcome, and none showing reliable or clinically significant deterioration. Specifically, there were significant reductions in depression, anxiety and beliefs about voices from pre-post therapy. Participants’ rankings of the importance of different group therapeutic factors were very similar to those observed in face-to-face mindfulness for psychosis groups. Qualitative analysis of participant feedback identified three themes: ‘experience of online delivery’, ‘therapeutic benefits’ and ‘feeling connected to people in the group’.

Conclusions

Findings in relation to therapy engagement, clinical benefits, participant experience and group process offer encouragement that online delivery of mindfulness for psychosis groups may be a useful addition to mental health services for people with distressing voices that seek inclusive patient choice.

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