The Key to Integrated Trauma Treatment in Psychosis Trial
The Key to Integrated Trauma Treatment in Psychosis (Kit) Trial: a Pragmatic, Multicenter Effectiveness RCT of EMDR for Trauma Symptoms in Schizophrenia Spectrum Disorders
Haukeland University Hospital
187 participants
Sep 1, 2024
INTERVENTIONAL
Conditions
Summary
Schizophrenia spectrum disorders (SSDs) have a significant trauma etiology: trauma has been reported in 65 - 80% in this patient group and have a negative impact on prognosis. Trauma treatment is currently not offered in SSDs due to a lack of evidence. KIT is a pragmatic trial comparing the effectiveness of added trauma focused therapy, Eye Movement Desensitization and Reprocessing (EMDR) to standard treatment in SSDs. The study will compare EMDR as add on to treatment as usual (TAU) to TAU in patients with schizophrenia spectrum disorders (SSDs). The overall aim is to examine the effectiveness of EMDR on trauma symptoms in SSDs. Participants will receive max. 26 sessions of EMDR, and complete assessments before, during and after the course of therapy, in addition to a period of time (6 months) after therapy to examine long-term effects.
Eligibility
Inclusion Criteria6
- aged ≥ 16 years
- diagnosis of F20-29 in the ICD-10 assessed using SCID 5 CV
- reporting trauma \> 1 month prior to assessment
- being currently distressed by the reported trauma(s), i.e., ≥ 5 (from 0 = not at all, to 10 = extremely) on item 21c on the Trauma and Life Events Checklist (TALE)
- able and motivated for engaging in trauma focused (TF) therapy
- able to understand and give informed consent; consent capacity for psychological treatment choices and consent to study procedures.
Exclusion Criteria8
- primary diagnosis of substance use/alcohol dependence
- inability to understand spoken Norwegian
- organic psychosis or a neurological disorder
- acute state of psychosis defined as:
- hospitalized in an acute ward the last 6 weeks or
- major change in antipsychotic medication type or started/stopped antipsychotic medication last 6 weeks or
- other mental health crises last 6 weeks
- current or previous (past 6 months) TF therapy
Interventions
EMDR aims to treat and process trauma by safely retrieving the trauma memories while taxing the working memory. EMDR targets trauma symptoms through memory reprocessing of traumatic memories, and consists of eight flexible phases: history taking/case conceptualization; preparation for memory reprocessing; assessment/identification of a target memory; desensitization/reprocessing; installation of positive cognition; body scan; closure; and re-evaluation. EMDR in the current trial has psychosis-specific adaptations including focus on psychoeducation, preparation for reprocessing and patient safety. Techniques targeting dissociation, psychotic symptoms and psychosis-related challenges are included.
Locations(2)
View Full Details on ClinicalTrials.gov
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NCT06608706