Catherine Iredale1,2, Miriam Fornells-Ambrojo1,2,3, Suzanne Jolley1. 1. a Department of Psychology , King's College London, Institute of Psychiatry, Psychology and Neuroscience , London , UK . 2. b South London and Maudsley NHS Foundation Trust , London , UK , and. 3. c Department of Clinical , Educational and Health Psychology, University College London , London , UK.
Abstract
BACKGROUND: People with psychosis often have difficulty leaving their homes to perform tasks of daily living, which also limits their access to clinic-based interventions to support recovery. Home-based psychological therapy may offer a solution. AIM: To examine service user and therapist perspectives on (i) houseboundness in psychosis and (ii) the value of home-based psychological interventions, as a first step towards a systematic evaluation. METHOD: Semistructured interviews with 10 service users and 12 therapists from a large inner city mental health NHS Foundation Trust were thematically analysed. RESULTS: Houseboundness most commonly resulted from anxiety, paranoia and amotivation, indicating the potential usefulness of targeted psychological therapies. Home-based therapy was offered unsystematically, with variable goals. Although beneficial for engagement and assessment, little gain was reported from undertaking a full course of therapy at home. CONCLUSION: Home visits could be offered by psychological therapists to engage and assess housebound service users, but home-based therapy may be best offered on a short-term basis, targeting paranoia, anxiety and amotivation to increase access to other resources. Given the increased cost associated with home-based psychological interventions, a systematic evaluation of their impact is warranted.
BACKGROUND:People with psychosis often have difficulty leaving their homes to perform tasks of daily living, which also limits their access to clinic-based interventions to support recovery. Home-based psychological therapy may offer a solution. AIM: To examine service user and therapist perspectives on (i) houseboundness in psychosis and (ii) the value of home-based psychological interventions, as a first step towards a systematic evaluation. METHOD: Semistructured interviews with 10 service users and 12 therapists from a large inner city mental health NHS Foundation Trust were thematically analysed. RESULTS: Houseboundness most commonly resulted from anxiety, paranoia and amotivation, indicating the potential usefulness of targeted psychological therapies. Home-based therapy was offered unsystematically, with variable goals. Although beneficial for engagement and assessment, little gain was reported from undertaking a full course of therapy at home. CONCLUSION: Home visits could be offered by psychological therapists to engage and assess housebound service users, but home-based therapy may be best offered on a short-term basis, targeting paranoia, anxiety and amotivation to increase access to other resources. Given the increased cost associated with home-based psychological interventions, a systematic evaluation of their impact is warranted.
Entities:
Keywords:
Schizophrenia; access; community mental health; engagement; low-intensity