Engagement with early intervention in psychosis services
Research type
Research Study
Full title
Autonomy, psychological reactance, and engagement with early intervention services for individuals experiencing first episode psychosis
IRAS ID
335911
Contact name
William Sellwood
Contact email
Sponsor organisation
Lancaster University
Clinicaltrials.gov Identifier
n/a, n/a
Duration of Study in the UK
1 years, 2 months, 27 days
Research summary
Research Summary:
Autonomy, psychological reactance, and engagement with early intervention services for individuals experiencing first episode psychosis Lancaster University
15.08.2024 to 21.01.2025
We would like to extend our gratitude to everyone who took part in the research study.
Public involvement played a crucial role in shaping this study. An individual with lived experience of psychosis and mental health services were involved in the design and method of the study and reviewed the study materials.
The research took place across two NHS trust and online peer support networks. The research was necessary because engagement with early intervention services can vary. Previous research has suggested this may be because people with psychosis may feel their autonomy and choice is threatened under mental health services. Psychological reactance argues that when autonomy is threatened, people may become motivated to restore their feeling of autonomy through their behaviour. Therefore, individuals with psychosis may disengage with early intervention services to feel they have more autonomy and choice in their life. Engagement is important to understand to improve outcomes for people with psychosis. The main questions we sought to answer were, does autonomy predict engagement in early intervention services and is this relationship mediated by psychological reactance?
82 participants took part in the study. They received a questionnaire during the research which they could complete anonymously. It asked about their sense of autonomy in early intervention services, their engagement levels and their level of psychological reactance.
Data from the questionnaires was analysed using a mediated regression. The key results showed that autonomy predicted engagement. Autonomy did not predict psychological reactance, and psychological reactance did not predict engagement. There was a significant positive relationship between age and autonomy, suggesting that older individuals felt more autonomous in their care with early intervention services.
This research has contributed to a better understanding of engagement with early intervention services, highlighting the importance of giving people (particularly young people) more autonomy. Further research to look at how particular interventions could be implemented to improve autonomy (such as Shared Decision Making or Open Dialogue approaches), would build on the findings of this study.
To learn more about this study, you can visit Lancaster University Website.Psychosis is a mental health difficulty which affects well-being, distress and risk of suicide. Key symptoms include hallucinations (seeing or hearing things that others do not) and delusions (fixed unusual beliefs). Getting support for psychosis early on can improve the likelihood of recovery, improving mental and physical health outcomes. Early intervention services were developed to support people as soon as possible after symptoms had started. For people to get the most out these services, good engagement is needed; however, for some, engagement is only partial and potentially non-existent. The reasons why people may not engage or disengage with early intervention services is not fully understood. However, there is research that suggests that when people’s autonomy and freedom of choice is threatened, they are likely to act in ways that help restore their sense of autonomy. This is called psychological reactance. The aim of this study is to see whether sense of autonomy in treatment and reactance are associated with engagement with early intervention services. Surveys will be used to ask people who currently use early intervention services or who have done recently, about autonomy, reactance and engagement and then will be analysed to look at the relationships between these different factors.
REC name
London - Westminster Research Ethics Committee
REC reference
24/PR/0680
Date of REC Opinion
8 Jul 2024
REC opinion
Further Information Favourable Opinion