Cited by 50Schizophrenia research and treatmentPsychotherapy Techniques and ApplicationsMental Health and Psychiatry

Targeting Recovery in Persistent Persecutory Delusions: A Proof of Principle Study of a New Translational Psychological Treatment (the Feeling Safe Programme)

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Freeman, Daniel, Bradley, Jonathan, Waite, Felicity, Sheaves, Bryony, DeWeever, Natalie, Bourke, Emilie, McInerney, Josephine, Evans, Nicole +4 more·2016·Behavioural and Cognitive Psychotherapy

Abstract

BACKGROUND: Many patients do not respond adequately to current pharmacological or psychological treatments for psychosis. Persistent persecutory delusions are common in clinical services, and cause considerable patient distress and impairment. Our aim has been to build a new translational personalized treatment, with the potential for wide use, that leads to high rates of recovery in persistent persecutory delusions. We have been developing, and evaluating individually, brief modular interventions, each targeting a key causal factor identified from our cognitive model. These modules are now combined in "The Feeling Safe Programme". AIMS: To test the feasibility of a new translational modular treatment for persistent persecutory delusions and provide initial efficacy data. METHOD: 12 patients with persistent persecutory delusions in the context of non-affective psychosis were offered the 6-month Feeling Safe Programme. After assessment, patients chose from a personalized menu of treatment options. Four weekly baseline assessments were carried out, followed by monthly assessments. Recovery in the delusion was defined as conviction falling below 50% (greater doubt than certainty). RESULTS: 11 patients completed the intervention. One patient withdrew before the first monthly assessment due to physical health problems. An average of 20 sessions (SD = 4.4) were received. Posttreatment, 7 out of 11 (64%) patients had recovery in their persistent delusions. Satisfaction ratings were high. CONCLUSIONS: The Feeling Safe Programme is feasible to use and was associated with large clinical benefits. To our knowledge this is the first treatment report focused on delusion recovery. The treatment will be tested in a randomized controlled trial.

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  • The counterweight model underlies the face-to-face Feeling Safe program and the guided online program Feeling Safer, both of which have shown strong treatment effects.

    “The counterweight model we describe here was developed to guide both psychological understanding and treatment, and underlies the face-to-face Feeling Safe program (Freeman et al., 2016) and the guided online program Feeling Safer (Freeman et al., in revision), both of which have shown strong treatment effects.”

    From A counterweight model for understanding and treating persecutory delusions. (2025) · cites this paper as Freeman et al., 2016

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Authors
Freeman, D., Bradley, J., Waite, F., Sheaves, B., DeWeever, N., Bourke, E., McInerney, J., Evans, N., Černis, E., Lister, R., Garety, P., & Dunn, G.
Affiliations
  • University of Oxford (GB)
  • King's College London (GB)
  • University of Manchester (GB)
Corresponding author
Freeman, Daniel
Venue
Behavioural and Cognitive Psychotherapy
Published
2016-04-05
Volume
44
Issue
5
Pages
539-552
ISSN
  • 1352-4658 (ISSN-L)
  • 1469-1833
OpenAlex
W2315125390
Cited by
50
References
46
Citations by year
2026: 6 · 2025: 8 · 2024: 3 · 2023: 4 · 2022: 4 · 2021: 1 · 2020: 4 · 2019: 9 · 2018: 4 · 2017: 5 · 2016: 2
FWCI
5.92
Type
journal article
Language
en
Open access
Locations
  • Behavioural and Cognitive Psychotherapy (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • University of Birmingham Research Portal (University of Birmingham) (submittedVersion)
  • Research Portal (King's College London) (submittedVersion, cc-by)
Funders
  • National Institute for Health and Care Research
  • Medical Research Council (G0902308)
Topics
  • Health Sciences › Medicine › Psychiatry and Mental health › Schizophrenia research and treatment
  • Social Sciences › Psychology › Clinical Psychology › Psychotherapy Techniques and Applications
  • Social Sciences › Arts and Humanities › Philosophy › Mental Health and Psychiatry
Keywords
persecutory delusions, non-affective psychosis, treatment feasibility, treatment satisfaction
MeSH terms
Adult, Anxiety, Anxiety Disorders, Delusions, Emotions, Feasibility Studies, Female, Humans, Male, Middle Aged, Paranoid Disorders, Pilot Projects, Psychiatric Status Rating Scales, Psychotic Disorders, Cognitive Behavioral Therapy

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