Social networks can shrink dramatically for young people recovering from psychosis. ACU’s School of Psychology is involved in collaborative research that is opening up a new perspective online, writes Sara Coen.
Facebook for young people who are functioning well might be a block to engaging in meaningful face-to face social activities; however for those in the aftermath of psychosis, online social networking can become a safe way to reconnect to the world.
ACU’s School of Psychology is participating in an innovative study to support the development and testing of a moderated online social therapy that aims to support the long-term recovery of young people who have experienced first episode psychosis (FEP).
The Horyzons project is investigating the important question of whether the clinical benefits of FEP programs can be extended into long-term improvements through the use of online psychosocial interventions.
Early intervention for psychosis has emerged as a major international psychiatric reform. The transformation of psychiatric care has led to the proliferation of specialist FEP services in Australia, Europe, North America and Asia.
Early intervention services have changed the face of psychosis treatment, improving psychotic symptoms, reducing relapse rates and fostering engagement with services and patient satisfaction.
However, there are still some major challenges to achieving the aims of early intervention, including the long-term maintenance of treatment benefits. Horyzons is a collaboration between ACU, the University of Melbourne, the Orygen Youth Health Research Centre and Deakin University – and is led by Dr Mario Alvarez-Jimenez, a Senior Research Fellow at the Orygen Youth Health Research Centre in Melbourne.
Competitive grants have been awarded to the research team from the Victorian Government Mental Illness Research Fund (MIRF), The Institute for a Broadband-Enabled Society (IBES), the Telstra Foundation, The Telematics Trust, The Helen MacPherson Trust and the University of Melbourne.
ACU Professor of Psychology John Gleeson said, “Horyzons is an online platform that integrates peer-to-peer social networking, individually tailored psychosocial interventions and expert moderation – and has been specifically designed to support young people who are recovering from psychosis and to prevent their disengagement from mental health services.”
A highly specialised team of psychologists, computer programmers, web designers, graphic artists and professional writers are working alongside the research team to develop the platform, which has now been three years in the making.
“Young people who are recovering from psychosis can become extremely socially disconnected. In the acute phases of their mental illness, they may have experienced hallucinations, persecutory delusions, depression and severe anxiety – all of which can prevent them from engaging in meaningful social activities,” said Professor Gleeson.
“Many of these young people have lost contact with their friends altogether, and are at risk of dropping out of school and work. They are also faced with social stigmas attached to having a mental illness – and social phobia can then become a big problem.”
“They need some sort of scaffolding to help reconnect with their peers and to build a network of support – and online interventions can be a safe way to venture out again after a period of social isolation.”
The Horyzons platform has been developed and designed with strong input from these young people themselves – a series of focus groups were conducted with consumers aged 15 to 25 from the Early Psychosis Prevention and Intervention Centre in Melbourne.
“We wanted to find out exactly what these young people were looking for in online support – and they told us they wanted the platform to be safe, supportive, flexible, user-friendly, reliable and informative. They were also extremely enthusiastic about online social networking,” said Professor Gleeson.
“Many of the elements of the platform are similar to that of Facebook – although Horyzons is a form of online social therapy that is highly moderated and safe.”
Horizons has a ‘café’ component which focuses on social engagement – including a ‘newsfeed’ where clients and moderators can post comments, upload pictures and videos, and ‘like’ various content. The system also has a ‘friends’ network and a ‘wall’ function displaying the activity of individual users.
There is a structured activity component that encourages users to take individual social risks – and activities may include everyday practical tasks such as making a phone call, or paying a bill.
There is also a ‘job zone’ where users are provided with information regarding vocational training and online access to a vocational rehabilitation expert.
“Activities are based on the principles of ‘positive psychology’ so there is a real focus on developing strengths rather than weaknesses,” Professor Gleeson said. “This is important as we are engaging with a fragile population, and we want the platform to help restore their confidence and self-esteem.”
The platform further incorporates a number of moderated social networking features that are progressively unlocked as patients advance through various therapy modules. For example, participants are invited to join moderated online problem solving groups. Research evaluations indicate Horyzons to be a promising online intervention as it yields high acceptance and usage, low attrition, high satisfaction, and perceived increased social connectedness and empowerment.
“Participants who have had the opportunity to trial the platform, have reported feeling safe,” said Professor Gleeson.
“The research findings may have significant implications for the enhancement of specialist mental health services in both Australia and overseas – and the potential of Horyzons to improve long-term recovery is worthy of further investigation”.