The role of "dose" of therapy and therapy formulation level in improvements in social support appraisals and concomitant reductions in suicidal ideation severity over 6 months in people with psychosis.
Patricia Gooding, Daniel Pratt, Connor Heapy, Kamelia Harris, Richard J Drake, Gillian Haddock
{"title":"The role of \"dose\" of therapy and therapy formulation level in improvements in social support appraisals and concomitant reductions in suicidal ideation severity over 6 months in people with psychosis.","authors":"Patricia Gooding, Daniel Pratt, Connor Heapy, Kamelia Harris, Richard J Drake, Gillian Haddock","doi":"10.1037/ccp0001009","DOIUrl":null,"url":null,"abstract":"<p><strong>Objective: </strong>The objectives were to examine the role of two therapy process variables (formulation level and therapy \"dose\") in a mechanism involving links between improved social support appraisals and reduced suicidal ideation severity over time in people with psychosis and to determine which aspects of social support were key to improvements in suicidal ideation.</p><p><strong>Method: </strong>Participants (N = 106) had nonaffective psychosis and recent suicidal experiences and had received a suicide-focused talking therapy. A model was tested in which, across 6 months, changes in social support appraisals were associated with changes in suicidal ideation severity with sequential mediators of therapy \"dose\" (number of sessions) and therapy formulation level (1-5). Multivariate techniques were used to probe which social support items clustered around suicidal ideation improvements and the two therapy process variables.</p><p><strong>Results: </strong>The highest levels of formulation (Levels 4 and 5) were attained by 77% of participants, with median therapy attendance of 17 sessions. Therapy \"dose\" and therapy formulation level acted as sequential mediators in a significant indirect pathway in which improvements to social support appraisals led to consequent improvements in suicidal ideation severity, with social support from family being key. Aspects of social connectedness of particular importance included feeling important to others, being able to rely on family, being relied upon by family, and being cared for by family.</p><p><strong>Conclusions: </strong>People with some of the most severe mental health problems can fully engage with suicide-focused therapy. Individualized formulation is recommended which is to focus upon transitions within social connectedness appraisals. (PsycInfo Database Record (c) 2026 APA, all rights reserved).</p>","PeriodicalId":15447,"journal":{"name":"Journal of consulting and clinical psychology","volume":"94 7","pages":"404-414"},"PeriodicalIF":6.0000,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of consulting and clinical psychology","FirstCategoryId":"102","ListUrlMain":"https://doi.org/10.1037/ccp0001009","RegionNum":1,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"PSYCHOLOGY, CLINICAL","Score":null,"Total":0}
引用次数: 0
Abstract
Objective: The objectives were to examine the role of two therapy process variables (formulation level and therapy "dose") in a mechanism involving links between improved social support appraisals and reduced suicidal ideation severity over time in people with psychosis and to determine which aspects of social support were key to improvements in suicidal ideation.
Method: Participants (N = 106) had nonaffective psychosis and recent suicidal experiences and had received a suicide-focused talking therapy. A model was tested in which, across 6 months, changes in social support appraisals were associated with changes in suicidal ideation severity with sequential mediators of therapy "dose" (number of sessions) and therapy formulation level (1-5). Multivariate techniques were used to probe which social support items clustered around suicidal ideation improvements and the two therapy process variables.
Results: The highest levels of formulation (Levels 4 and 5) were attained by 77% of participants, with median therapy attendance of 17 sessions. Therapy "dose" and therapy formulation level acted as sequential mediators in a significant indirect pathway in which improvements to social support appraisals led to consequent improvements in suicidal ideation severity, with social support from family being key. Aspects of social connectedness of particular importance included feeling important to others, being able to rely on family, being relied upon by family, and being cared for by family.
Conclusions: People with some of the most severe mental health problems can fully engage with suicide-focused therapy. Individualized formulation is recommended which is to focus upon transitions within social connectedness appraisals. (PsycInfo Database Record (c) 2026 APA, all rights reserved).
期刊介绍：
The Journal of Consulting and Clinical Psychology® (JCCP) publishes original contributions on the following topics: the development, validity, and use of techniques of diagnosis and treatment of disordered behaviorstudies of a variety of populations that have clinical interest, including but not limited to medical patients, ethnic minorities, persons with serious mental illness, and community samplesstudies that have a cross-cultural or demographic focus and are of interest for treating behavior disordersstudies of personality and of its assessment and development where these have a clear bearing on problems of clinical dysfunction and treatmentstudies of gender, ethnicity, or sexual orientation that have a clear bearing on diagnosis, assessment, and treatmentstudies of psychosocial aspects of health behaviors. Studies that focus on populations that fall anywhere within the lifespan are considered. JCCP welcomes submissions on treatment and prevention in all areas of clinical and clinical–health psychology and especially on topics that appeal to a broad clinical–scientist and practitioner audience. JCCP encourages the submission of theory–based interventions, studies that investigate mechanisms of change, and studies of the effectiveness of treatments in real-world settings. JCCP recommends that authors of clinical trials pre-register their studies with an appropriate clinical trial registry (e.g., ClinicalTrials.gov, ClinicalTrialsRegister.eu) though both registered and unregistered trials will continue to be considered at this time.
求助内容：
应助结果提醒方式：
京公网安备 11010802042870号
