Active assistance for psychological therapy
National clinical guidelines recommend a treatment known as cognitive behavioural therapy (CBT) for people who have experienced psychosis. To help increase access to helpful strategies, we are developing a CBT-informed mobile phone app (Actissist) for people who have experienced a first episode of psychosis.
The app was tested in an initial pilot trial in 2015/16 and the results are available in the publications section below. We have now received funding to conduct a larger-scale randomised controlled trial over three years (until October 2020).
The aims of this project are to see whether:
- people will use the app
- people like using the app
- the app improves people’s mental health.
Who is eligible to take part?
- accessing services from an early intervention team or community mental health team;
- accessing services from Greater Manchester Mental Health NHS Foundation Trust or Pennine Care NHS Foundation Trust;
- experienced a first episode of psychosis within the past five years;
- 16 years of age or over.
How can people take part?
Who funds this research and who granted ethical approval?
We have a number of published studies available for free online.
Actissist proof-of-concept trial results
In our proof-of-concept trial, we found that Actissist appeared to be acceptable and safe to use, people enjoyed using the app, and it showed promise for treatment efficacy. Full results are available in Schizophrenia Bulletin.
World Psychiatry Letter
Developing a measure to assess therapeutic alliance
Actissist proof-of-concept study protocol
Staff focus groups
We recently conducted focus groups with staff working in secondary care services to explore their views towards the use of digital health interventions in mental health care settings. We found that staff were cautiously optimistic about the potential role that digital tools could play in mental health services. See the results.
We also conducted staff focus groups as part of the Actissist proof-of-concept trial. Early Intervention staff were again optimistic about the potential for a CBT-informed app for individuals with early psychosis. Our findings are available here.
Qualitative interviews with service users
During the proof-of-concept study we interviewed participants who had experienced a first episode of psychosis. Participants were largely positive about the use of an app for psychosis because they had the potential to be progressive, modern and relevant. However, data security and privacy concerns were raised as barriers that could impact willingness and desire to use an app. The full results from these interviews can be found here.
Members of our research team also interviewed 18 participants experiencing severe mental health problems about their views towards the use of technology in secondary care services. Participants already used technology to self-manage their mental health and could see a variety of benefits of using technology in their day-to-day lives, but similar concerns regarding security and data access were raised, as well as the fear that technology may be used to replace face-to-face care. Our full results are available online
In the news
- Phone app has promising signs for mental health patients
- Patients with early psychosis may benefit from app on how to cope with symptoms
- The Mental Elf website recently published a blog summarising our research exploring the views of mental health staff towards digital health interventions.
We are regularly updating the website with the milestones and achievements over this three year project. You can also see regular updates written by members of the research team on our project blog.
October to December 2018
- By the end of December 2018, we recruited 85 participants to the trial (exactly half way to our total recruitment target). This was a huge achievement – thanks to all the research staff, NHS staff, our expert reference and participants for helping us reach this point!
- Sandra presented Actissist at the IEPA 11 Conference as part of a digital health symposium. More details about the IEPA conferences can be found if you click on the following link: https://www.iepaconference.org/iepa11/
- In October, Sandra was invited to be a keynote speaker at the Global E-Mental Health conference in Australia: https://www.newcastle.edu.au/research-and-innovation/global-leadership/e-mental-health
- We published our qualitative work with service users exploring their views towards the role of digital technology in the management of psychosis in JMIR Mental Health.
July to September 2018
- We recruited a total of 57 participants by the end of September 2018.
- We held our quarterly Expert Reference Group where we asked for feedback on the next version of the Actissist app and future study materials.
- We released Actissist version 2 to new participants on the trial.
April to June 2018
- We held a public and patient involvement group with service users who had all experienced early psychosis to co-design two recovery videos that we could add to the recovery video section on the app based on feedback from the Actissist proof-of-concept study and completed filming in June.
- We recruited 33 participants to the project between April and June 2018.
- Actissist was presented at the annual Pint of Science event in Manchester.
- The findings from the proof-of-concept study were published in the journal Schizophrenia Bulletin.
January to March 2018
- We held our first expert reference group, where we presented the app for the first time to the group and sought feedback on specific features such as the topics the app covers and factsheet subjects and project design such as recruitment methods.
- Sandra Bucci (Principal Investigator) and Natalie Berry (Research Assistant) attended the European Society for Research on Internet Interventions (ESRII) 5th Scientific Meeting in Dublin to present the findings from the Actissist proof-of-concept study and qualitative interviews with service users exploring views towards digital health for psychosis.
- We have started to visit early intervention services and community mental health teams in two Greater Manchester NHS Trusts to show staff the Actissist app.
- We started recruiting participants to the trial.
- By the end of March, we recruited our first four participants.
October to December 2017
- We received NHS ethics approval.
- We set-up an Actissist Trial Steering Group Committee/Data and Ethics Committee, which will meet annually to review the progress of the trial.
- We also set-up a dedicated expert reference group, a group of individuals with lived experience, clinicians, academics and software engineers, to collaborate and co-design project and app features.
- Sandra Bucci (Principal Investigator), Gillian Haddock (Co-Investigator) and Natalie Berry (Research Assistant) travelled to Berlin for the International Society for Research on Internet Interventions (ISRII) 9th Scientific Meeting to present findings from several projects including the Actissist proof-of-concept study and qualitative work with mental health care staff exploring views towards digital health.
The Actissist app was developed and trialled over a 26-month period. We found that the Actissist app appeared to be safe and acceptable for people experiencing early psychosis.
We have now started a large-scale, randomised controlled trial which will run until October 2020.
We will continually work to improve and develop the app, and the development will be informed by both service users and staff. We are trialling the app to see whether:
- people like using the app
- the app improves people’s mental health.
Find out more about our methods below.
Staff and service user design
Expert reference group
Meet members of the research team behind the Actissist app and view their research profiles for more information.
Professor Sandra Bucci – Principal Investigator
Professor John Ainsworth – Co-Investigator
Professor Gillian Haddock – Co-Investigator
Professor Katherine Berry – Co-Investigator
Professor Dawn Edge – Co-Investigator
Professor Richard Emsley – Co-Investigator
Professor Shôn Lewis – Co-Investigator
Mr Matthew Machin – Technical lead
Matt has over 20 years’ experience in software engineering as a developer, software development manager and technical programme manager. He currently leads a multi-disciplinary team of software engineers, UI designers, software test specialists and project managers based in the Health e-Research Centre. Matt’s primary area of interest is Connected Health including the development of smartphone apps and the use of wearable devices for people with long-term health conditions.
Dr Natalie Berry – Research Associate
Natalie joined The University of Manchester in 2014 as a PhD student investigating how technology can be used to deliver psychological interventions for people who experience severe mental health problems and was awarded her PhD in January 2018. Her research interests focus on exploring how people currently use technology to self-manage their mental health, the acceptability of digital health interventions for severe mental health problems, and the impact of technology use on symptoms. Natalie joined the Actissist 2.0 team in October 2017 and works as the research associate on the project.
Dr Elizabeth Lewis – Research Assistant
- the effectiveness of interventions within preschool speech and language therapy;
- historical research considering Whittingham Asylum to inform future mental health interventions;
- and the management of adult social care, which was the focus of her PhD.
Recently she has considered the effectiveness and implementation of digital interventions for bipolar and psychosis.
Dr Alyson Williams – Project Officer
Rose Dickin - Research Assistant
Hannah is an undergraduate Psychology student at the University of Manchester, who joined the Actissist 2.0 team in June 2019 as a summer intern. She is interested in how the future of mental health care, with innovations like e-health, can be made broadly accessible to reach people
Hannah Davies - Summer Intern
Hannah is an undergraduate Psychology student at the University of Manchester, who joined the Actissist 2.0 team in June 2019 as a summer intern. She is interested in how the future of mental health care, with innovations like e-health, can be made broadly accessible to reach people.