2024-09-23 13:23:51
The psychosocial rehabilitation program “Alice” aims to help patients reduce their conviction regarding persecutory delusions. A two-year multicenter research project initiated at CH Le Vinatier aims to evaluate its effectiveness.
Funded as part of the CH Le Vinatier 2023 Research Projects, the Alice research (for “Aid to the interpretation of behaviors and emotions”) aims to validate a new psychosocial rehabilitation intervention, based on cognitive behavioral therapies (CBT) and work on emotions, designed to reduce conviction regarding delusional ideas of persecution in patients suffering from severe psychiatric disorders. Delusional ideas of persecution are indeed a frequent symptomatology (70% of patients suffering from schizophrenia), transdiagnostic, for which few targeted therapies are available. The effectiveness of antipsychotics is modest on this symptomatology (1), while that of cognitive and behavioral therapies (CBT) is low (2).
In this context, a team composed of two nurses (Isabelle Seguin and Yves Berthier) and a psychologist (Rémi Prunet) has developed the Alice program for 6 years. This is an intervention for groups of 8 patients, transdiagnostic, organized in 16 one-hour sessions. They take place around a game, which features a fictional character, Alice, struggling with everyday life situations during which she feels persecuted. Each episode, constructed from real events experienced by patients, is then dissected by the group, with the aim of helping people become aware of the emotion/thought/behavior triangulation. Gradually, patients identify that their attribution biases are linked to their negative emotions in their environment. They are then motivated to enroll in other therapeutic groups on self-affirmation, social cognitions or engage in individual therapy.
After a preliminary study, this multicenter research will take place at CH Le Vinatier and CHU de Saint-Étienne. It will involve 45 patients for two years. The main hypothesis is that the conviction regarding delusional ideas of persecution is reduced after participation in the Alice program. The results will be evaluated for 9 months using several scales. If the results are positive, the Alice program, easy to use and transposable, could fill an important gap in first-level psychiatric care, offering a non-pharmacological option in the treatment of these delusional ideas of persecution.
• Contact : Romain Rey, Romain.REY@ch-le-vinatier.fr
1– Leucht et al. (2013). Comparative efficacy and tolerability of 15 antipsychotic drugs in schizophrenia : a multiple treatments meta-analysis. Lancet Lond Engl. 382(9896):951-62. 2– Van der Gaag M et al. (2014), Smit F. The effects of individually tailored formulation-based cognitive behavioural therapy in auditory halluinations and delusions : a meta-analysis. Schizophr Res. juin 2014 ;156(1):30-7.
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#Reducing #Persecutory #Delusions
