Seven-step Phenomenological Psychotherapy for Self-disorder - a Pilot Study (SSPP-SD-p)

The goal of this clinical pilot study is to learn how adults with schizophrenia or other non-affective psychotic disorders or psychosis risk syndromes experience a novel psychotherapeutic treatment for self-disorders. The study has a qualitative, phenomenological research design. After end of treatment, the participants are interviewed about the experience of the treatment. This include how the participants liked it, if it was experienced as helpful and useful, and changes in self-experience and experience of relations to others and the world.

Study Overview

• Status: Recruiting
• Conditions: Psychosis;Schizophrenic
• Intervention / Treatment: Behavioral: Seven-step phenomenological psychotherapy for self-disorders

Detailed Description

Self-disorders are considered as central features of schizophrenia spectrum disorders which may be present both before, during, and after psychotic episodes. They are characterized by disturbances in the sense of ownership to experiences and agency of action, as well as in the sense of presence, reality and existence. They are further considered to drive symptom development during prodromal schizphrenia. Self-disorders may be very painful, and associated with anxiety, disturbances in daily functioning and increased sucidality. There is a lack of studies investigating the effect of psychotherapy on self-disorders. Hence, there is a need for developing and testing new treatment approaches to these debilitating conditions.

In this pilot study the investigators want to test a new model and manual for the treatment of self-disorders, the Seven-Step Phenomenological Psychotherapy for Self-Disorder (SSPP-SD), first developed by Dr.Med Paul Møller. This model focuses on the phenomenological exploration of self-disorders, subjective understanding, meaning and associated behaviors, psychoeducation, and the joint exploration of new meanings and understanding related to the experiences. The length of the treatment is stipulated to 14 individual sessions over 7-10 weeks. The first step of the treatment involves a semi-structured interview with the Examination of Anomalous Self-Experience (EASE).

The study has a qualitative phenomenological design where the primary research question is how the participants experienced the treatment. In more detail, the investigators want to explore both positive and negative experiences, how useful or helpful the participants experienced the treatment, and how the treatment affected self-experience and experience of relations to others and the world. These experiences will be explored in a qualitative interview following the end of treatment. In addition, the participants will answer questionnaires regarding symptoms, functioning, life quality (before and after treatment) and satisfaction with the treatment (after treatment). The study will inform the planning of a larger clinical trial testing the effect of the SSPP-SD on self-disorders in participants with psychotic disorders at Vestre Viken Hospital, Norway. Hence, in this pilot study the investigators will also register and evaluate therapist experiences of the SSPP-SD, and fidelity to the manual. The therapists will be supervised by Dr.med Paul Møller.

Six participants with schizophrenia or other ICD-10 F20-29 disorders, or with psychosis risk syndromes as defined in the Structured Interview for Psychosis-risk Syndromes (SIPS) will be included. They will be included from an outpatient clinic for psychotic disorders at Akershus University Hospital, Norway. Two experienced therapists trained in the model will offer the therapy, including project leader Dr. Tor Gunnar Værnes at the Oslo University Hospital.

• Study Type: Interventional
• Enrollment (Estimated): 8
• Phase: Not Applicable

Contacts and Locations

• Study Contact: Name: Tor Gunnar Værnes, Dr.philos.; Phone Number: 0047 92 45 56 78; Email: uxvrnt@ous-hf.no
• Study Contact Backup: Name: Paul Møller, Dr.Med.; Phone Number: 0047 91 17 60 84; Email: Paul.Moller@vestreviken.no

Study Locations

• Norway
  • Oslo, Norway
    • Completed
    • Akershus University Hospital
  • Bærum
    • Sandvika, Bærum, Norway, 1338
      • Recruiting
      • Bærum DPS
      • Contact: Lise Baklund, PhD; Phone Number: 0047 91542993; Email: Lise.Baklund@vestreviken.no
      • Sub-Investigator: Lise Baklund, PhD

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult
• Accepts Healthy Volunteers: No

Description

Inclusion Criteria:

• Clinical diagnoses in the ICD-10-CM Code range, i.e. schizophrenia, schizotypal, delusional, and other non-mood psychotic disorders. First diagnosed no more than 3 years ago.
• Or Psychosis risk syndrome as defined in the Structured Interview of Psychosis-Risk Syndromes (SIPS) (McGlashan, Walsh, & Woods, 2010)
• Present with anomalous self-experiences, as confirmed by the Screen Questionnaire for EASE (SQuEASE-6) (Møller, 2018)
• Motivated to explore and work with anomalous self-experiences in psychotherapy

Exclusion Criteria:

• Severe, ongoing psychosis
• Severe, ongoing drug abuse
• IQ<70
• Poor Norwegian language profiency

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Allocation: N/A
• Interventional Model: Single Group Assignment
• Masking: None (Open Label)

Number of Arms

1

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Other: Psychotherapy group; Single arm of participants receiving a phenomenologically oriented psychotherapeutic intervention	Behavioral: Seven-step phenomenological psychotherapy for self-disorders; Phenomenological exploration of anomalous self-experiences, meaning attributions and behavioral consequences. Psychoeducation. Dialogical approach focusing on self-narratives, searching for new meaning and understanding of self-disorders

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Experience of the seven-step phenomenological psychotherapy model for self-disorders	Qualitative, semi-structured interview exploring how the participants experienced the therapy.	After completing the SSPP-SD treatment, up to 12 weeks after study inclusion

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
General Anxiety Disorder-7 (GAD-7)	Self-report of anxiety symptoms scored on a 0-3 Likert scale. Min-max score on the total scale: 0-21. Higher scores reflect more severe symptoms/outcome	Before the SSPP-SD intervention and at the end of the intervention, up to 12 weeks after enrollment
Patient Health Questionnaire-9 (PHQ-9)	Self-report of 9 depression symptoms. Each symptom scored on a 0-3 Likert scale. Min-max scores 0-27. Higher scores imply a more severe outcome	Before the SSPP-SD intervention and at the end of the intervention, up to 12 weeks after enrollment
Work and Social Adjustment Scale (WSAS)	Self-report measure for impairment in social and work functioning and adjustment. It includes 5 items to be scored on a 0-8 Likert scale. Min-max score 0-40. Higher scores imply a more severe outcome	Before the SSPP-SD intervention and at the end of the intervention, up to 12 weeks after enrollment
Warwick-Edinburgh Mental Well-Being Scale (WEMWBS)	Self-report measure for mental well-being. It includes 14 items each scored on a 1-5 Likert scale. Min-max score: 14-70. Higher scores imply a more severe outcome.	Before the SSPP-SD intervention and at the end of the intervention, up to 12 weeks after enrollment
Positive and Negative Syndrome Scale-6 (PANSS-6)	Brief rating scale for the measurement of severity in schizophrenia. A semi-structured interview assessing 3 positive and 3 negative symptoms. Each symptom scored on a 1-7 Likert scale. Min-max total score: 6-42. Higher scores imply more severe outcomes	Before the SSPP-SD intervention and at the end of the intervention, up to 12 weeks after enrollment
10-point self-disorder questionnaire	Brief rating scale for the measurement of self-disorders. It includes 10 items, each scored on a 0-4 Likert scale. Min-max score 0-40. Higher scores imply a more severe outcome	Before the SSPP-SD intervention and at the end of the intervention, up to 12 weeks after enrollment
Examination of Anomalous Self-Experience (EASE)	Semi-structured interview for a qualitative exploration and quantitative assessment of anomalous self-experiences. It includes 57 main items, each scored on a 0-4 Likert scale (it also include a range of subitems which are scored on a 0-4 Likert scale, but the scores on these subitems are not included in the total EASE score). Min-max total score 0-228. Higher scores imply more severe outcomes	During the first of sevens steps of treatment, session 1 and 2. Up to 3 weeks after study enrollment
Client Satisfaction Questionnaire (CSQ-8)	Self-report measure of satisfaction with health-care, including 5 questions. Each question scored on a 0-4 Likert scale. Total scores range from 8 to 32, with the higher number indicating greater satisfaction.	After end of SSPP-SD treatment, up to 12 weeks after enrollment

Collaborators and Investigators

• Sponsor: Oslo University Hospital
• Collaborators: Vestre Viken Hospital Trust; University Hospital, Akershus
• Investigators: Principal Investigator: Tor Gunnar Værnes, Dr.philos., Oslo University Hospital, Early Intervention in Psychosis Advisory Unit for South-East Norway

Study record dates

Study Major Dates

• Study Start (Actual): October 17, 2024
• Primary Completion (Estimated): March 1, 2026
• Study Completion (Estimated): March 1, 2026

Study Registration Dates

• First Submitted: September 9, 2024
• First Submitted That Met QC Criteria: September 12, 2024
• First Posted (Actual): September 19, 2024

Study Record Updates

• Last Update Posted (Estimated): December 9, 2025
• Last Update Submitted That Met QC Criteria: December 2, 2025
• Last Verified: November 1, 2025

More Information

Terms related to this study

• Keywords: psychotherapy; qualitative; phenomenology; schizophrenia spectrum; psychosis risk syndrome; self-disorder
• Additional Relevant MeSH Terms: Schizophrenia Spectrum and Other Psychotic Disorders; Psychotic Disorders; Mental Disorders
• Other Study ID Numbers: 750920

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO
• IPD Plan Description: Due to the qualitative, phenomenological design, and the small number of participants

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No
• product manufactured in and exported from the U.S.: No