Department of Psychology, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, UK.
South London and Maudsley NHS Foundation Trust, London, UK.
Psychol Psychother. 2022 Sep;95(3):717-737. doi: 10.1111/papt.12395. Epub 2022 Apr 28.
Cognitive Behavioural Therapy (CBT) is an effective psychological intervention for sleep difficulties and has been used successfully in individuals with psychosis. However, access is restricted due to lack of resources and staff training. Delivering CBT for sleep problems using smartphone technology may facilitate wider access. This study aimed to evaluate the feasibility, acceptability and potential usefulness of a guided, smartphone-based CBT intervention targeting sleep disturbance for individuals with psychosis.
Participants with psychosis spectrum diagnoses were recruited to a single-arm, uncontrolled study and engaged with the seven-module programme via smartphone app for six weeks with therapist support.
Feasibility was assessed by rates of referral, recruitment and completion. Acceptability was assessed by app usage, a satisfaction questionnaire and qualitative analysis of participants' semi-structured interview. Pre- and post-intervention assessment of sleep, psychotic experiences, mood, well-being and functioning was conducted. Mean change confidence intervals were calculated and reported as an indication of usefulness.
Fourteen individuals consented to participation, and eleven completed the post-intervention assessment. On average, each participant engaged with 5.6 of 7 available modules. Qualitative feedback indicated the intervention was considered helpful and would be recommended to others. Suggested improvements to app design were provided by participants. Potential treatment benefits were observed for sleep difficulties, and all outcomes considered, except frequency of hallucinatory experiences.
It is feasible and acceptable to deliver therapist-guided CBT for sleep problems by smartphone app for individuals with psychosis. This method provides a low-intensity, accessible intervention, which could be offered more routinely. Further research to determine treatment efficacy is warranted.
认知行为疗法（CBT）是一种针对睡眠困难的有效心理干预措施，已成功应用于精神疾病患者。然而，由于资源和人员培训的缺乏，其应用受到限制。使用智能手机技术提供睡眠问题的 CBT 可能会增加其可及性。本研究旨在评估针对精神疾病患者睡眠障碍的智能手机引导式 CBT 干预措施的可行性、可接受性和潜在有效性。
招募了具有精神分裂症谱系诊断的参与者，进行了一项单臂、非对照研究，他们通过智能手机应用程序在六周内与治疗师一起参与了七个模块的计划。
通过转介、招募和完成率评估可行性。通过应用程序使用情况、满意度问卷和参与者半结构化访谈的定性分析评估可接受性。在干预前后评估睡眠、精神病体验、情绪、幸福感和功能。计算了平均变化置信区间，并报告了其有用性的指示。
十四名参与者同意参与，十一名完成了干预后的评估。平均而言，每位参与者参与了 7 个可用模块中的 5.6 个。定性反馈表明该干预措施被认为是有帮助的，并将推荐给其他人。参与者提供了对应用程序设计的改进建议。观察到睡眠困难有潜在的治疗益处，除了幻觉体验的频率外，所有结果都被认为是有意义的。
通过智能手机应用程序为精神疾病患者提供治疗师引导的 CBT 治疗睡眠问题是可行且可接受的。这种方法提供了一种低强度、可及性强的干预措施，可以更常规地提供。需要进一步研究来确定治疗效果。
