Current Research Opportunities

The PPiP study aims to understand if some cases of psychosis are caused by immune system problems in some people. The immune system normally controls our ability to fight infection. If the immune system goes wrong it may cause diseases called ‘autoimmune’ diseases. We can diagnose some of these autoimmune diseases using blood tests. We are specifically interested in antibodies affecting the N-methyl D-aspartate receptors (NMDA-r) or other neuronal membrane targets that may be the cause symptoms of psychosis and possibly cause some cases of schizophrenia. We are working with Early Intervention in Psychosis (EIP) services across England to estimate the prevalence of these autoimmune diseases in people with first episode psychosis.

A multi-centre diagnostic randomised controlled trial of disclosure of results of plasma p-tau217 to community memory clinic patients and clinicians in the UK.

Alzheimer’s disease (AD) is the commonest sub-type diagnosis for people who have mild cognitive impairment (MCI) or dementia. Confirming AD currently requires either expensive amyloid PET scans, or invasive lumbar punctures, to which most people who are diagnosed with MCI or AD in community memory clinics in the UK do not have access. However, recent research shows that AD can be detected early and accurately using blood tests, the most promising of which is plasma p-tau217. Funded by the Alzheimer’s Research UK Blood Biomarker Challenge, ADAPT is a multi-centre randomized controlled trial of disclosure of plasma p-tau217 results to patients and memory service clinicians in up to 20 community memory clinics across the UK. The p-tau217 result will be added to a standard assessment for people referred to the memory clinic for the first time, whom the memory clinician judges may have MCI or dementia that could be due to AD. Out of 1100 people taking part, half will find out their p-tau217 results after 3 months, and the remainder after 12 months. Follow up over 15 months will find out whether the p-tau217 result makes a difference to how many people are diagnosed with AD, the treatment and care received, costs of care, quality of life and experience of the diagnostic pathway. The evidence from this study will be used to help to assess whether this blood test should be included in the standard of care in memory clinics in the NHS.

Care (Education) and Treatment Reviews (C(E)TRs) are meetings that take place to ensure that people with learning disability (LD) or autism receive the right support in the community and are only admitted to hospital when there is no alternative. To date, little is known about whether C(E)TRs help to reduce hospital admissions and promote good outcomes, how people with LD, autism, their carers, and professionals feel about C(E)TRs or how they think C(E)TRs can be improved. This NIHR-funded project includes three linked studies: 1) Prospective Cohort Study, 2) Qualitative Interview Study, 3) Delphi Panel Study.

In 1) 300 people with LD and autistic people who have a higher likelihood of being admitted to hospital will be recruited via NHS services. Participants (with carers) will have three assessments over 12 months. We will ask about admissions to hospital, their mental health, quality of life, and what care and treatment they have received. We will investigate if there is a difference in these things between people who have a C(E)TR during the study and people who do not.

In 2) we will interview people with LD and autistic people, carers, health and social care professionals who have recently had or attended a C(E)TR, recruited via NHS services, professional and/or social networks. We will ask people about their experiences to understand what is working well with C(E)TRs and what needs to change.

In 3) we will try to find out what aspects of a C(E)TR are most important to people with LD, autistic people, carers, professionals, and other C(E)TR panel members. They will complete an online questionnaire and rate different statements. We will use the results to create a checklist to guide professionals on running high-quality and effective C(E)TRs.

RCT of group CBT for men with intellectual and/or developmental disabilities and harmful sexual behaviour: the HaSB-IDD trial. Summary: The public are concerned about men who commit sexual offences. Cognitive behavioural treatment seems to help non-disabled men when they have committed sex offences. This treatment is available in prisons, probation and in health settings, and research shows this can be helpful in stopping men from reoffending.

Some men who commit sex offences have learning disabilities or autism. However, these men often do not get any treatment. This project will offer men with learning disabilities and/or autism the same kind of treatment that non-disabled men get. The treatment has been specifically adapted for them and is called SOTSEC-ID. We will look at whether this is helpful for the men, in the way they feel and the way they behave. Men with learning disabilities and/or autism who have harmful sexual behaviour, from 4 areas of England, will be asked to join the project. They will be randomised to get Treatment as Usual (TAU) or the special new treatment, called SOTSEC-ID, which is a form of group CBT. They will be asked how they feel and what they think, and we will record any harmful sexual behaviours, at the start of the research, then 6 months later, then one year later, and two years later. The research will last for 54 months overall, and if the treatment is successful, the men will be less risky so that they do not commit (or commit fewer) sexual offences. A positive result will improve public safety, and reduce the number of victims. It is also likely to mean that the cost of care for the men is lower.

Children and young people who come into contact with the police often need help. This trial aims to test out whether offering these children and young people a psychological treatment called Brief Solution Focused Therapy is helpful. Brief Solution Focused Therapy (BSFT) is a short-term therapy that helps people to change by focusing on building solutions rather than getting stuck thinking about problems. Children and young people will be randomly allocated to get either BSFT plus the routine treatment that they would normally get, or to get the routine treatment that is currently offered after police contact. All of the children and young people who take part will be asked to complete some measures of things that may change because of taking part in Brief Solution Focused Therapy. We are particularly interested in whether they are involved in any antisocial behaviours over the course of the trial. We will also ask about their background, their general well-being, any criminal activity they have been involved with in the past and any gang connections. We will also interview some of the children and young people receiving SFBT, their parents/guardians, and the professionals that deliver the SFBT therapy. We will ask them about their experiences of taking part in the trial.

HPFT is a Data Collection Centre for this Research Database, which became eligible for Portfolio adoption in September 2024.

This research is looking at the use of virtual reality interventions for autistic young people with anxiety, to see how autistic young people experience this intervention and whether it helps with anxiety. As it is new research in this area, a programme has been developed in partnership with a Virtual Reality company using existing research and feedback from autistic young people. It will follow a Cognitive Behavioural Therapy (CBT) approach, teaching attention training and relaxation strategies through virtual reality and using virtual reality ‘exposure’ to anxiety provoking scenarios. Participants will also take a headset home to practice the skills and exposure. Young people will be asked to complete questionnaires to help measure changes in anxiety and responses to Virtual Reality. Qualitative feedback will also be collected. As it is in the development stages, it is a feasibility study, and will focus on testing the intervention with a small group of 12-18 year olds. If the intervention looks like it is useful and acceptable to autistic young people, then this would inform further clinical trials to compare this with other interventions.

There is strong evidence that Cognitive Behavioural Therapy (CBT) is an effective treatment for anxiety and depression. NHS Talking Therapies are the main provider of mental health treatments in England, including CBT. Whilst CBT is a ‘talking’ therapy, it also involves practical tasks that are vital for overcoming problems. Patients are encouraged to practise what they have learned between therapy sessions. However, many patients struggle with this. Unfortunately, patients do not typically receive any support from their therapist between sessions. Lack of such support could be a major contributor to patients leaving treatment early or being unable to make progress. Currently, we know little about what patients do between sessions, how they use their learning, what they find helpful or difficult, and how this impacts their progress. We need to understand this so we can design ways to support patients between sessions, using efficient digital methods. This study will explore patients’ use of between-session time using online surveys and interviews.

Persecutory delusions (inaccurate beliefs that others intend to harm you) are very common in mental health conditions such as schizophrenia. Existing treatments often don’t work well enough. This study tests a guided online web app called Feeling Safer, developed by the study team, for adults attending psychosis services who have a persecutory delusion.

Feeling Safer will be tested in a multi-centre randomised controlled trial. 484 patients with persecutory delusions will be randomised to one of four conditions: Feeling Safer (added to standard care) supported by peer support workers, or graduate mental health workers, or CBT therapists, or standard care. A smaller number of patients, Feeling Safer deliverers, and other mental health staff will also be interviewed to learn more about the therapy and how it may be used in the NHS. 

Most people with psychosis report sleep problems that are troubling for them, that exacerbate affective and psychotic symptoms, and that make thinking and everyday functioning more difficult. We aim to conduct the first definitive test of the idea that psychological therapy can help people with psychosis to enjoy greatly improved sleep and that this will lead to gains in many other aspects of people’s lives. 

We will conduct a multi-centre randomised controlled clinical trial, evaluating the effects of a psychological therapy for sleep problems in patients at ultra-high risk of psychosis and patients with a diagnosis of non-affective psychosis. Assessments will be conducted at 0, 12 (end of treatment), and 24 weeks. 

This research study aims to improve our understanding about whether and how eating disorder (ED) symptoms might be related to how young people use the internet. This research study focuses on young people aged 14-25, who are currently engaging with NHS treatment for ED symptoms. In the first part of the study, participants will answer questionnaires about their internet use and other aspects of their lives, including the ED symptoms that they are experiencing. This will allow us to see whether there are links between a range of different online activities and ED symptoms. In the second part of the study, we will ask a smaller group of young people to take part in interviews, so we can understand their thoughts about how the internet might be related to ED symptoms.

Care (Education) and Treatment Reviews (C(E)TRs) were introduced in 2014, to try to reduce the number of people with learning disabilities and autistic people being admitted to psychiatric hospitals and to encourage discharge of those already within hospital. However, we know very little about whether C(E)TRs lead to successful outcomes and how they can be improved. In this research project, we will evaluate C(E)TRs and assess whether they are helpful for people with learning disabilities and autistic people and their families. Within Stage 2, we will find out how patients in hospital are doing over time, by attending Care (Education) and Treatment Reviews, Care Programme Approach (CPA), and other patient meetings. We will ask people, including people with moderate and severe learning disabilities to take part in interviews, ensuring that these are adapted to be accessible for everyone. We will use the information from these observations and interviews to work out whether Care (Education) and Treatment Reviews are helping people and making things better.

Social Anxiety Disorder (SAD) is a common and disabling mental health problem. Cognitive Therapy for Social Anxiety Disorder (CT-SAD) is recommended by the National Institute for Health and Care Excellence (NICE) as the first-line treatment for SAD in the NHS and is highly effective. Full treatment cannot always be delivered due to resource constraints and therapist workloads, and patients can also find it difficult to attend weekly sessions. Therefore, it is desirable to improve the accessibility of CT-SAD, by reducing the therapist time required without compromising on treatment outcomes.

Internet-delivered treatment could provide a solution to these challenges. An internet-based cognitive therapy for SAD (iCT-SAD) has been developed, which allows therapists to guide patients through an online programme that patients can access in their own time at a place convenient to them. This randomised controlled trial directly compares iCT-SAD to usual NHS treatment for SAD in a real-world setting. The trial will investigate whether iCT-SAD leads to greater improvement in SAD symptoms and recovery rates than TAU and will examine its cost-effectiveness compared to TAU. It will also examine how satisfied patients and therapists are with the internet-delivered treatment.

Posttraumatic Stress Disorder (PTSD) is a common and disabling mental health problem. Cognitive Therapy for Posttraumatic Stress Disorder (CT-PTSD) is recommended by the National Institute for Health and Care Excellence (NICE) as the first-line treatment for PTSD in the NHS and is highly effective. Full treatment cannot always be delivered due to resource constraints and therapist workloads, and patients’ difficulty to attend weekly sessions. Internet-delivered treatment could provide a solution to these challenges. An internet-based cognitive therapy for PTSD (iCT-PTSD) has been developed, which allows therapists to guide patients through an online programme that patients can access in their own time at a place convenient to them. This randomised controlled trial directly compares iCT-PTSD to usual NHS treatment for PTSD in a real-world setting. The trial will investigate whether iCT-PTSD leads to greater improvement in PTSD symptoms and recovery rates than TAU and will examine its cost-effectiveness compared to TAU. It will also examine how satisfied patients and therapists are with the internet-delivered treatment.