Group-based Metacognitive Therapy for Burns and Plastics Patients
Research type
Research Study
Full title
Group-based Metacognitive Therapy for anxiety and mood symptoms in burns and plastics patients: a feasibility and acceptability study
IRAS ID
287367
Contact name
Adrian Wells
Contact email
Sponsor organisation
University of Manchester
Clinicaltrials.gov Identifier
Clinicaltrials.gov Identifier
N/A, N/A
Duration of Study in the UK
1 years, 8 months, 2 days
Research summary
Serious burns and other traumatic or disfiguring injuries represent a significant public health burden. Survivors often need intense medical or surgical treatment, including plastic surgery. As well as devastating physical injuries, up to 45% of people develop significant mental health difficulties following a traumatic injury. These difficulties include depression, anxiety and post-traumatic stress disorder (PTSD). Cognitive Behavioural Therapy (CBT) is the most widely offered treatment within the NHS and the most common treatment provided for burns and plastics patients. However, CBT is limited in efficacy, time-consuming, and focuses on treating the most distressing problem first. One way to overcome these limitations is to evaluate a group therapy that can treat multiple mental health problems at once. One such treatment is called Metacognitive Therapy (MCT; Wells 2009). MCT targets metacognitive beliefs (beliefs people hold about their thinking) rather than the content of patients’ thoughts (i.e. reality testing), which is advantageous over cognitive therapies as often following a burns or plastics injury patients experience realistic negative thoughts(e.g. thoughts about disfigurement). MCT has been shown to be more effective at treating anxiety and depression in mental health settings than CBT, however, more research is needed to evaluate MCT in physical health settings.The aim of this study is to examine the acceptability and feasibility of group-MCT within the Department of Burns, Plastics and Reconstructive Surgery at Wythenshawe Hospital. We aim to recruit 20 patients to receive six weekly sessions of group-MCT. Sessions will last approximately 90 minutes. Indicators of feasibility and acceptability will be described including rates of referrals, recruitment, and dropout. Data on symptom outcomes (as measured by the PHQ-9 and GAD-7) at pre and post treatment will be assessed and benchmarked against usual treatment delivered. The data will be used to inform a future large-scale trial on the effectiveness of MCT.
Group-based Metacognitive Therapy for Burns and Plastics:
Closing summary for research participantsBackground:
Burn injuries, physical trauma, or medical conditions/treatments that require plastic or reconstructive surgery can cause significant psychological distress. It is common for people that experience these injuries or surgeries to have mental health difficulties such as trauma symptoms, anxiety, or low mood. It is important that appropriate psychological support is offered to this patient group. One potential psychological treatment is called Metacognitive Therapy (MCT). Research has shown that MCT is effective in mental health settings, but it has never before been used in a burns and plastics service.
Method:
The aim of this study was to examine whether a study of group based MCT (group-MCT) was feasible and acceptable for this patient group. Adult outpatients were recruited from the psychology service within a burns and plastic surgery department at a hospital in Manchester, UK. They were assigned to six sessions of group-MCT delivered over video call. Participants completed psychological questionnaires at the start of the study, after 4 months and after 7 months. We wanted to explore how many people signed up to the study, how many dropped out, how many attended sessions and how many completed questionnaires and how useful the questionnaires were.
Results:
Fourteen people signed up to the study in a four-month period. Three people dropped out during the therapy. On average, participants attended 4 out of 6 sessions. All participants completed the questionnaires at the start of the study, and there was variation in participant’s scores, suggesting the questionnaires were useful. Nine participants (64.29%) completed questionnaires at month 4, and seven (50%) completed them at the month 7 time point. This rate of completion was lower than our target of 80%.
Conclusion:
A study of group-MCT appears to be acceptable and feasible in this patient group, but attention needs to be given to questionnaire completion rates. The findings from this study could be used to design future larger scale studies which explore how effective group-MCT is in burns and plastics services.REC name
West of Scotland REC 4
REC reference
21/WS/0033
Date of REC Opinion
10 Mar 2021
REC opinion
Favourable Opinion