2020 - Now

2020 - Now



The Cost-Effectiveness of a Novel Online Social Therapy to Maintain Treatment
Effects From First-Episode Psychosis Services: Results From the Horyzons
Randomized Controlled Trial

This research into the cost-effectiveness of digital mental health interventions shows online, mobile and social media interventions can be a cost-effective and promising ongoing treatment approach for young people experiencing mental ill-health.

The study was conducted alongside the Horyzons randomised control trial and evaluated its cost effectiveness based on change in social functioning plus a cost-utility analysis.  

Authors: Engel, L., Mario Alvarez-Jimenez, M., Cagliarini, D., D’Alfonso, S., Faller, J., Valentine, L., Koval, P., Sarah Bendall, S., Shaunagh O’Sullivan, S., Rice, S., Miles, C., Penn, D., Phillips, J., Russon, P., Lederman, R., Killackey, E., Lal, S., Cotton, S., Gonzalez-Blanch, C., Herrman, H., McGorry, P., Gleeson J., and Mihalopoulos, C. (2023). 
Schizophrenia Bulletin, sbad071


The Horyzons project: a randomised controlled trial of a novel online social therapy to maintain treatment effects from specialist first-episode psychosis services

This study was the first randomised controlled trial (RCT) to demonstrate that a digital intervention was effective in improving employment prospects and educational attainment – core components of social recovery. The trial also demonstrated that, in early psychosis, the digital intervention reduced reliance on emergency services, which is a key goal of specialised first-episode psychosis services.

Authors: Alvarez-Jimenez, M., Koval, P., Schmaal, L., Bendall, S., O’Sullivan, S., Cagliarini, D., D’Alfonso, S., Rice, S., Valentine, L., Penn, D. L., Miles, C., Russon, P., Phillips, J., McEnery, C., Lederman, R., Killackey, E., Mihalopoulos, C., Gonzalez-Blanch, C., Gilbertson, T., & Lal, S. (2021). 
World Psychiatry, 20(2), 233–243.

Young people’s experience of online therapy for first-episode psychosis: A qualitative study. Psychology and Psychotherapy: Theory, Research and Practice 

This qualitative study found young people experience online therapy in a variety of ways. They may use it for on-demand help-seeking, mental health normalisation, as a positive distraction from distress, and to revise and practice therapeutic strategies. Some young people were motivated by the flexibility of online therapy, while others found the perceived choices to be overwhelming. 

The study found that on-demand help-seeking and positive distraction were unique to online therapy and may help explain the significant reduction of young people presenting to emergency departments and a non-significant trend for lower hospitalisations in the intervention group of the Horyzons RCT outlined previously.

Authors: Valentine, L., McEnery, C., O’Sullivan, S., D’Alfonso, S., Gleeson, J., Bendall, S., & Alvarez-Jimenez, M. (2021)., 95(1).


Young People’s Experience of a Long-Term Social Media-Based Intervention for First-Episode Psychosis: A Qualitative Analysis

This qualitative study found that an online therapeutic social network can foster belonging and connection and normalise mental health experiences for young people. It also found that low usage of the platform is not necessarily linked to disinterest, but to the barriers young people face when trying to use it. Common barriers included social anxiety, internalised stigma, paranoia and pressure to provide peer support to others. 

Challenging the assumption that ‘low users’ are ‘disinterested users’, and instead exploring what factors inhibit people from engaging with an intervention as they wish to, could have direct implications for fostering engagement with digital mental interventions.

Authors: Valentine, L., McEnery, C., O’Sullivan, S., Gleeson, J., Bendall, S., & Alvarez-Jimenez, M. (2020). Journal of Medical Internet Research.

A Novel Multimodal Digital Service (Moderated Online Social Therapy) for Help-Seeking Young People Experiencing Mental Ill-Health: Pilot Evaluation Within a National Youth E-Mental Health Service 

This study revealed Moderated Online Social Therapy (MOST) to be a feasible, acceptable and safe online clinical service for young people with mental ill-health. The results support the therapeutic potential of MOST+ with significant improvements recorded in psychological distress, perceived stress, psychological well-being, depression, loneliness, social support and self-competence.

Authors: Alvarez-Jimenez, M., Rice, S., D’Alfonso, S., Leicester, S., Bendall, S., Pryor, I., Russon, P., McEnery, C., Santesteban-Echarri, O., Da Costa, G., Gilbertson, T., Valentine, L., Solves, L., Ratheesh, A., McGorry, P. D., & Gleeson, J. (2020). Journal of Medical Internet Research, 22(8), e17155. https://doi.org/10.2196/17155

Read more of our publications:

- Rice, S., O'Bree, B., Wilson, M., McEnery, C., Lim, M., Hamilton, M., . . . Álvarez-Jiménez, M. (2020, 5 5). Development of a graphic medicine-enabled social media-based intervention for youth social anxiety. Clinical Psychologist, cp.12222.

- Bailey, E., Alvarez-Jimenez, M., Robinson, J., D’Alfonso, S., Nedeljkovic, M., Davey, C., . . . Rice, S. (2020, 4 3). An Enhanced Social Networking Intervention for Young People with Active Suicidal Ideation: Safety, Feasibility and Acceptability Outcomes. International Journal of Environmental Research and Public Health, 17(7), 2435.

- Ludwig, K., Browne, J., Nagendra, A., Gleeson, J., D'Alfonso, S., Penn, D., & Alvarez-Jimenez, M. (2020, 2 17). Horyzons USA: A moderated online social intervention for first episode psychosis. Early Intervention in Psychiatry, eip.12947.

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