Heather Law

• PhD in Clinical Psychology
• Project Manager at Greater Manchester Mental Health NHS Foundation Trust

Background The At Risk Mental State (ARMS) (also known as the Ultra or Clinical High Risk) criteria identify individuals at high risk for psychotic disorder. However, there is a need to improve prediction as only about 18% of individuals meeting these criteria develop a psychosis with 12-months. We have developed and internally validated a predicti...

Background Early intervention in psychosis (EIP) services improve outcomes for young people, but approximately 30% disengage. Aims To test whether a new motivational engagement intervention would prolong engagement and whether it was cost-effective. Method We conducted a multicentre, single-blind, parallel-group, cluster randomised controlled tri...

Background People with severe mental illness experience physical health inequalities and a 15–20-year premature mortality rate. Forensic inpatients are particularly affected by restrictions on movement, long admissions, and obesogenic/sedative psychotropic medication. We aimed to establish the feasibility and acceptability of Motiv8, a multidiscipl...

Objectives This study aims to review studies developing or validating a prediction model for transition to psychosis in individuals meeting At Risk Mental State (ARMS) criteria focussing on predictors that can be obtained as part of standard clinical practice. Prediction of transition is crucial to facilitating identification of patients who would...

Background Physical health inequalities of people with serious mental illness (SMI) have been labelled an international scandal; due to the 15–20-year reduction in life expectancy associated with poor physical health. This occurs at an early stage and evidence shows young people with and at risk for SMI are a particularly vulnerable group requiring...

Introduction People with severe mental illness have physical comorbidities which result in significant reductions in quality of life and premature mortality. Effective interventions are required that are suitable for people in secure forensic mental health services. We conducted pilot work of a multidisciplinary weight management intervention (Moti...

Introduction People with severe mental illness have physical comorbidities which result in significant reductions in quality of life and premature mortality. Effective interventions are required that are suitable for people in secure forensic mental health services. We conducted pilot work of a multidisciplinary weight management intervention (Moti...

Aims and Method A retrospective service evaluation of the first 500 referrals to a new community forensic service (FCAMHS) describing profiles of young people accessing the service. The evaluation aims to understand the impact of changes in health service care models and diversion from youth justice services over the last two decades in England. Ac...

Background Early Intervention in Psychosis (EIP) services improve health outcomes for young people with psychosis in the medium–long term, but 25% of young people disengage in the first 12 months with costs to their mental health, families, society and the NHS. This study will evaluate the effectiveness, cost-effectiveness and implementation of a t...

Therapeutic relationships have been widely recognized as crucial to good outcomes in psychotherapy. However, there is comparatively little research on what constitutes and impacts therapeutic relationships in the context of child and adolescent mental health services (CAMHS). Relationships within CAMHS are inherently complex, with multiple relation...

Objective Serious mental illness is associated with physical health comorbidities, however most research has focused on adults. We aimed to synthesise existing literature on clinical and behavioral cardiometabolic risk factors of young people on mental health inpatient units. Methods A systematic review and meta-analysis was conducted, using elect...

Aim A large proportion of individuals with an at‐risk mental state (ARMS) live at home and are supported by their families. Recommended treatment includes family intervention (FI), and therefore, understanding relationships between individuals with an ARMS and their family members is key. This study aimed to provide a more holistic exploration of r...

High levels of Expressed Emotion (EE) are present in families of individuals with an At‐Risk Mental State (ARMS) of psychosis and can negatively impact on service users’ functioning and symptoms, as well as relatives’ psychological wellbeing. Objectives This is the first longitudinal study to assess EE from the family/carers’ perspective, as well...

Background: Despite wide usage of the Questionnaire about the Process of Recovery 10 (QPR), the minimum important difference (MID) for the measure has not been identified. Establishing the MID for the QPR is required in order to facilitate the interpretation of outcomes in clinical practice and the use of this scale in research, to measure meaningf...

Objectives: The Bipolar at Risk Trial (BART) was a feasibility randomized controlled trial investigating cognitive behavioral therapy (CBT) compared with treatment as usual (TAU) in young people at high risk of developing bipolar disorder (BD). This qualitative study aimed to investigate participants' experiences of trial involvement, and the acce...

Background Recovery from psychosis is increasingly being viewed as a combination of symptomatic, functional, and personal recovery. Negative and depressive symptoms have been linked to community functioning, and negative affect has been linked to personal recovery. The current study examines differential associations of symptoms with functional and...

Aim Physical health inequalities experienced by people with mental health conditions are labelled an international scandal; due to the 15 to 30‐year gap in life expectancy, driven mostly by physical health conditions. Lifestyle interventions are recommended to prevent the onset of poor physical health in people with mental illness. Yet, there is le...

Individuals with an at‐risk mental state (ARMS) of psychosis experience high levels of distress, anxiety, low mood, and suicidal ideation. Families of ARMS individuals provide significant support but are often neglected by services. This study is the first of its kind to use a novel longitudinal qualitative methodology to directly compare family/ca...

Background: There is extensive literature documenting the nature of recovery in mental health in adult populations, but there is very little exploring its nature and meaning for young people. Aims: To gain a detailed understanding from the perspective of young people about the concept of recovery in young people’s mental health. Method: Semi struct...

Aims: Current National Institute for Health and Care Excellence (NICE) guidelines for psychosis recommend psychological therapy with or without family intervention for individuals at-risk of developing psychosis. NICE guidelines have a specific research recommendation to investigate the clinical and cost effectiveness of combined individual and fa...

Providing care can be demanding and is associated with increased financial, emotional and psychological distress. Relatives of individuals with At-Risk Mental State (ARMS) of psychosis provide significant emotional, practical and economic support but are often a neglected group. The current study aimed to investigate the barriers and facilitators f...

Aims and method: To assess physical health needs of adolescent in-patients by routine monitoring. A retrospective analysis of case notes was conducted on a 6-month intake to generic and secure adolescent mental health units in Greater Manchester, UK. Results: Fifty individuals were admitted (52% female, average age 15.84 years). Diagnoses varied...

The At-Risk Mental State (ARMS) for psychosis describes a state of high but not inevitable risk for developing a psychotic disorder. The distressing experiences for individuals with an ARMS may impact on themselves; their sense of wellbeing, psychosocial functioning and their family. Expressed emotion (EE) considers the environment and communicatio...

Background: Little evidence is available for head-to-head comparisons of psychosocial interventions and pharmacological interventions in psychosis. We aimed to establish whether a randomised controlled trial of cognitive behavioural therapy (CBT) versus antipsychotic drugs versus a combination of both would be feasible in people with psychosis. M...

Background: Clinical guidelines recommend cognitive behaviour therapy (CBT) for people with psychosis, however, implementation is poor and not everyone wishes to engage with therapy. Understanding service user (SU) preferences for receiving such treatments is a priority for services. Aims: To explore SU preferences and outcomes of different methods...

Purpose: Research suggests that the way an individual understands a health difficulty can influence their subsequent behaviour. The aim of this study was to explore the psychometric properties of a new causal belief questionnaire for people who have experience of psychosis. We also planned to provide an overview of current causal beliefs within th...

Background Previous evidence suggests that how an individual conceptualises the cause of a health problem can impact on subsequent perceptions and behaviour. Aims This study explored the beliefs about the causes of psychosis in a group of mental health professionals. The study also sought to examine the relationship between causal beliefs and the...

Aims: Ongoing NICE guidance recommends research on the clinical and cost effectiveness of psychological treatment alone, compared to antipsychotic medication and compared to psychological treatment and antipsychotic medication combined. The COMPARE study (Cognitive behaviour therapy or Medication for Psychosis- A Randomised Evaluation) was a pilot...

Written for practitioners and policymakers, this book will help professionals across health, education, social care and juvenile justice services to understand the needs of young offenders and adolescents at risk of entering the criminal justice system. Developmental in approach, the textbook provides a comprehensive overview of forensic child and...

This study presents a qualitative evaluation of a novel cognitive behavioural therapy targeting suicidal thoughts and behaviours for people experiencing psychosis. Eight participants from four NHS Trusts in the northwest of England were interviewed. The interview schedule was collaboratively developed with a Service User Reference Group whose membe...

Background Recovery in mental health is a relatively new concept, but it is becoming more accepted that people can recover from psychosis. Recovery-orientated services are recommended for adult mental health, but with little evidence base to support this. Objectives To facilitate understanding and promotion of recovery in psychosis and bipolar d...

Objectives: Research has suggested that the extent to which voices (i.e., auditory verbal hallucinations) are experienced as distressing might be influenced by negative beliefs about voices as well as maladaptive metacognitive styles involving the negative appraisal and maladaptive control of mental experiences. This cross-sectional study examined...

Background Research has highlighted the importance of recovery as defined by the service user, and suggests a link to negative emotion, although little is known about the role of negative emotion in predicting subjective recovery.AimsTo investigate longitudinal predictors of variability in recovery scores with a focus on the role of negative emotio...

Young people in custodial care are known to have high levels of mental health and emotional problems, and recent policy and service developments have sought to improve their access to services. However, little is known about how they cope or about what would increase their uptake of services (when such services are available). This study aimed to d...

Youth crime and youth violence blights our communities and shapes the lives of many, whether they are victims, perpetrators or family members. This book examines the application of psychological thinking and practice when working with young people who display high risk behaviours across a broad range of forensic mental health settings in the UK. It...

Background Existing psychological therapies for bipolar disorders have been found to have mixed results, with a consensus that they provide a significant, but modest, effect on clinical outcomes. Typically, these approaches have focused on promoting strategies to prevent future relapse. An alternative treatment approach, termed ‘Think Effectively A...

Background: Despite evidence for the effectiveness of structured psychological therapies for bipolar disorder no psychological interventions have been specifically designed to enhance personal recovery for individuals with recent-onset bipolar disorder. Aims: A pilot study to assess the feasibility and effectiveness of a new intervention, recove...

The latent structure, reliability and validity of the Questionnaire about the Process of Recovery (QPR) (Neil et al., 2009) were examined in a sample of participants with experience of psychosis (N = 335). The original two factor model proposed by Neil et al. (2009) was examined using exploratory factor analysis followed by a further independent ex...

Background Suicide behaviour in psychosis is a significant clinical and social problem. There is a dearth of evidence for psychological interventions designed to reduce suicide risk in this population. Aims To evaluate a novel, manualised, cognitive behavioural treatment protocol (CBSPp) based upon an empirically validated theoretical model. Meth...

https://www.escholar.manchester.ac.uk/uk-ac-man-scw:226526 This thesis explored conceptualisations of recovery, associated psychological factors and predictors, measurement of subjective recovery, and attitudes towards recovery. A multi-method approach was utilised, including reviewing evidence from the existing literature, cross-sectional, survey...

This study aimed to establish consensus about the meaning of recovery among individuals with experience of psychosis. A Delphi approach was utilized to allow a large sample of service users to be anonymously consulted about their views on recovery. Service users were invited to take part in a 3-stage consultation process. A total of 381 participant...

Health inequalities are high among offending groups. The comprehensive health assessment tool (CHAT) is a semi-structured assessment developed to provide a standardised approach to health screening for all young offenders admitted to the secure estate. The four sections of the CHAT (physical health, mental health, substance misuse and neurodisabili...

Subjective cognitive complaints are prevalent in those affected by functional psychoses and a variety of possible associated factors have been investigated. However, few studies have examined these potential factors within single studies or analyses. Patients with a history of a schizophrenia spectrum disorder (n = 115) and a non-clinical compariso...

Research suggests that both psychosocial factors and neuropsychiatric factors are important predictors of outcome, but little research has examined their relative importance to self-rated recovery. We aim to investigate how such factors are associated with subjective judgements of recovery from psychosis. Hundred and twenty two participants with ex...

Background: Recent conceptualisations of recovery from psychosis have recognised the importance of psychosocial aspects as well as the presence or absence of symptoms. Qualitative research and personal accounts of recovery highlight its subjective and idiosyncratic nature. This study aims to explore subjective judgements of recovery from the persp...

Background There is increasing evidence for the effectiveness of structured psychological therapies for bipolar disorder. To date however there have been no psychological interventions specifically designed for individuals with early bipolar disorder. The primary objective of this trial is to establish the acceptability and feasibility of a new CBT...

Mental health services are being encouraged to adopt a recovery approach, creating a requirement for standardised measures of recovery to be developed and embedded within services. Measurement of this unique concept is inherently difficult, but it is feasible and valid provided that service users and clinicians work collaboratively. To evaluate whi...

Longitudinal studies are helpful in understanding developmental trajectories and recognising opportunities for early intervention. This paper describes the long-term needs and mental health of an initial sample of male juvenile offenders, now adults 6 years after their index admission to secure care. In this prospective cohort study of 97 male juve...

The aim of this study was to conduct a preliminary evaluation of a mental health consultation process provided to staff working in residential care settings for young people. Using a semi-structured interview approach, qualitative information was gathered from six participants about their experiences of the consultation. A thematic analysis of the...

Relatively few studies have investigated the prevalence of young females with sexually abusive behaviours, and there is a lack of research comparing females with sexually abusive behaviours to a sample of non-sexually abusive delinquent females. The current pilot study explored the prevalence of sexually abusive behaviours in a sample of delinquent...

Asylum Seeker to RefugeeReferences

IntroductionNeed for Determination of MaturityPsychological Maturity as a ConceptCurrent PracticeSuggestions for a Framework for Good PracticeSummary and Conclusion Appendix 5.A Proposed Framework, Based on Common Assessment Framework (Department of Schools Families and Children, 2007)References