Examining the Effectiveness of Narrative Enhancement and Cognitive Therapy (NECT) and Enhanced Wellfocus Positive Psychotherapy for the People with Schizophrenia

Project: Research

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According to the Hong Kong Food and Health Bureau, about 45,000 people were diagnosed with schizophrenia in Hong Kong in 2017. Schizophrenia is a mental disorder that impacts individuals, families, and societies. While a range of medical services have been developed, psychotherapy for people with schizophrenia (PWS) that promotes their recovery and wellbeing is limited in local context. An enhanced WELLFOCUS Positive Psychotherapy (PPT)has been piloted to be effective in enhancing recovery of PWS in the half way houses (HWHs) by the Principal Investigator (PI). Further to this effort, the PI aims to adapt another recovery-oriented therapy, Narrative Enhancement and Cognitive Therapy (NECT) for use with PWS in Hong Kong. Hence, the objectives of our study are: (1) To further modify and adapt an enhanced WELLFOCUS PPT and NECT for PWS in local HWHs, (2) To compare the effectiveness of the enhanced WELLFOCUS PPT and NECT in improving self-efficacy, self-stigma, strength use, recovery, meaning making, symptom reduction, and wellbeing of PWS, (3) To understand the processes and mechanisms underlying the two interventions.A sequential exploratory mixed-method (QUAN-QUAL) design is employed. For the quantitative research, a randomized waitlist-control design is adopted. A total of 198 PWS will be recruited from 15 HWHs. Five HWHs will be randomly assigned to the trial arm 1 taking the enhanced WELLFOCUS PPT, five HWHs to trial arm 2 receiving NECT, and the remaining five to the trial arm 3 (waitlist control group with treatment-as-usual). We will conduct two groups in each HWH, with 7 PWS in each group. Modifications of the enhanced WELFOCUS PPT and NECT will be based on expert review and pilot study results. The actual implementation of each intervention will be held for approximately 5 months in different periods of the year. The same questionnaire will be administered to the participants before the intervention (T1), immediately after the intervention (T2) and six months after the intervention (T3). Multilevel regression analyses will be conducted to compare the immediate and maintenance effects. For the qualitative study, semi-structured interviews will be conducted to understand the participants’ experiences during the intervention, especially the factors that enable them to benefit from the interventions. Interpretative Phenomenological Analysis will be applied to guide the interview and analysis.The study integrates cutting-edged psychotherapy interventions that enhance wellbeing and recovery of PWS, and broadens the existing practices with PWS. It is an evidence-based study that will provide empirical evidence regarding the enhanced interventions, and will shed light on the possible change mechanisms and future model building. The study will facilitate the transition from a problem-focused, medical orientation to a recovery, strength-based positive psychotherapyorientation that emphasizes on the recovery and wellbeing of PWS. The validated interventions can be incorporated as routine activities in HWHs and hospitals to facilitate recovery of PWS. There is knowledge transfer from the research team to other academics, students, social workers, occupational therapists, and nurses to disseminate the knowledge and skills in helping PWS. As PWS improve and recover, more places in the hospitals and HWHs can be freed up for people on waiting lists, thus decreasing the medical and welfare costs in the long run. With evidence accumulated regarding the intervention effectiveness, we can urge the Government to promote psychotherapy interventions for PWS that supplement and enhance the medical approach, contributing to a change in the healthcare policy. The intervention protocols will be uploaded to the websites for promotion locally and internationally to benefit PWS worldwide. A globalplatform will also be established for international sharing and exchange on different mental health interventions.


Project number9043465
Grant typeGRF
StatusNot started
Effective start/end date1/01/23 → …