Social functioning in psychotic disorders
For people with psychotic disorders, social functioning, that is, the ability to maintain relationships, work, and participate in society, is often a major challenge. While traditional treatments focus on reducing symptoms such as paranoid ideation, social functioning often lags behind. This thesis explores several factors that could be targeted in therapy to improve social functioning, and how Virtual Reality (VR) can be used to provide better, more personalized support.
The research consists of two main parts. First, it investigates underlying psychological processes, such as social cognition (how we understand others) and the impact of negative symptoms (such as reduced motivation). Across the studies, reduced drive and motivation stood out as a major obstacle to social participation. Self-confidence also seemed to matter a lot, and communication skills may be a practical place to start in treatment.
The second part focuses on the development and evaluation of VR-SOAP, a modular Virtual Reality treatment. In this therapy, clinicians and clients work together in safe, simulated environments to practise social interactions. The pilot study showed that the treatment was feasible for therapists and well received by patients. While participants reported increased social confidence, actual changes in daily social activities were less clear. The research protocol is described, and the general discussion describes barriers to implementation and lessons learned from conducting the trial in routine care.
Overall, this thesis supports a more personal approach to improving social functioning in psychosis, based on the specific difficulties a person is dealing with.