Abstract

Objectives: SlowMo therapy is a pioneering blended digital therapy for paranoia, augmenting face-to-face therapy with an interactive ‘webapp’ and a mobile app.

A recent largescale trial demonstrated small–moderate effects on paranoia alongside improvements in self-esteem, worry, well-being and quality of life.

This paper provides a comprehensive account of therapy personalisation within this targeted approach.

Design: Case examples illustrate therapy delivery and descriptive data are presented on personalised thought content.

Method: Thought content was extracted from the webapp (n = 140 participants) and coded using newly devised categories: Worries: (1) Persecutory, (2) Negative social evaluation, (3) Negative self-concept, (4) Loss/life stresses, (5) Sensory-perceptual experiences and (6) Health anxieties.

Safer thoughts: (1) Safer alternative (specific alternatives to worries), (2) Second-wave (generalised) coping, (3) Positive self-concept, (4) Positive activities and (5) Third-wave (mindfulness-based) coping.

Data on therapy fidelity are also presented.

Results: Worries: ‘Persecutory’ (92.9% of people) and ‘Negative social evaluation’ (74.3%) were most common.

‘General worries/ life stresses’ (31.4%) and ‘Negative selfconcept’ (22.1%) were present in a significant minority; ‘Health anxieties’ (10%) and ‘Sensory-perceptual’ (10%) were less common.

Safer thoughts: ‘Second-wave (general) coping’ (85%), ‘Safer alternatives’ (76.4%), ‘Positive self-concept’ (65.7%) and ‘Positive activities’ (64.3%) were common with ‘Third-wave’ (mindfulness) coping observed for 30%.

Fidelity: Only three therapy withdrawals were therapy related.

Session adherence was excellent (mean = 15.2/16; SD = 0.9).

Behavioural work was conducted with 71% of people (119/168).

Conclusion: SlowMo therapy delivers a targeted yet personalised approach.

Potential mechanisms of action extend beyond reasoning.

Implications for cognitive models of paranoia and causal interventionist approaches are discussed.

Citations

Thomas Ward, Amy Hardy, Rebecca Holm, Nicola Collett, Mar Rus-Calafell, Catarina Sacadura, Alison McGourty, Claire Vella, Anna East3,4 | Michaela Rea1 | Helen Harding, Richard Emsley, Kathryn Greenwood, Daniel Freeman, David Fowler, Elizabeth Kuipers, Paul Bebbington, Philippa Garety. SlowMo therapy, a new digital blended therapy for fear of harm from others: An account of therapy personalisation within a targeted intervention. Psychol Psychother Theory Res Pract. 2021;00:1–24.

Sponsorship: Supported by the NIHR

DOI: https://DOI: 10.1111/papt.12377

URI: https://www.oxfordhealth.nhs.uk/orka/title/slowmo-therapy-a-new-digital-blended-therapy-for-fear-of-harm-from-others-an-account-of-therapy-personalisation-within-a-targeted-intervention/