{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,19]],"date-time":"2026-10-19T16:18:01Z","timestamp":1792426681327,"version":"4.5.0"},"reference-count":72,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2025,2,3]],"date-time":"2025-02-03T00:00:00Z","timestamp":1738540800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["bpspsychub.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Psychol Psychother"],"published-print":{"date-parts":[[2025,6]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>Disengagement from psychological therapies in first\u2010episode psychosis (FEP) is a common occurrence, with personal costs associated with untreated problems. This study aimed to establish the barriers and facilitators of people experiencing FEP to engagement in psychological therapies by undertaking a meta\u2010ethnography and Qualitative Comparative Analysis (QCA) of existing qualitative literature.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A systematic search was conducted in multiple databases including Psychinfo, Ovid Medline, Web of Science, EthOs, OPENgrey and Procrest in July 2021 (updated in July 2024). The search identified 6966 titles and 71 full texts that were reviewed for eligibility. Twenty\u2010three studies were found to meet eligibility and were critically appraised. Data was systematically extracted and synthesized in a meta\u2010ethnography and QCA.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Seven themes were identified as barriers to engagement in psychological therapy (Ambivalence to therapy, Emotional distress, Fluctuating symptoms, Negative expectations, Physical capacity, Service limitations and Therapy preference unmet) and six themes were identified as facilitators (Destigmatizing, Accessibility of digital therapy, Positive expectations of therapy are met, Service factors, Therapists interpersonal approach and skills and Therapy preferences met). The QCA identified a model with the Therapists interpersonal approach and skills, as sufficient (i.e. whenever that condition is present, the outcome is also guaranteed to be present) for engagement in psychological therapy, while Emotional distress was a sufficient barrier to engagement.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Engagement is a multifaceted construct with many factors unique to an individual's experience, impacted by emotional, social, practical and service\u2010level factors. Strengths, limitations and recommendations of the findings are discussed.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/papt.12576","type":"journal-article","created":{"date-parts":[[2025,2,3]],"date-time":"2025-02-03T07:28:56Z","timestamp":1738567736000},"page":"232-255","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Barriers and facilitators to engagement in psychological therapy in first episode psychosis: A meta\u2010ethnography and qualitative comparative analysis"],"prefix":"10.1111","volume":"98","author":[{"given":"Leanne","family":"Fahy","sequence":"first","affiliation":[{"name":"Research Department of Clinical, Educational and Health Psychology University College, London  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Linda","family":"Lee","sequence":"additional","affiliation":[{"name":"North East London NHS Foundation Trust Goodmayes Hospital  Ilford UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Liberty","family":"Newlove","sequence":"additional","affiliation":[{"name":"North East London NHS Foundation Trust Goodmayes Hospital  Ilford UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6640-8218","authenticated-orcid":false,"given":"Lisa","family":"Wood","sequence":"additional","affiliation":[{"name":"North East London NHS Foundation Trust Goodmayes Hospital  Ilford UK"},{"name":"Division of Psychiatry University College, London  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7316-3041","authenticated-orcid":false,"given":"Ciar\u00e1n","family":"O'Driscoll","sequence":"additional","affiliation":[{"name":"Research Department of Clinical, Educational and Health Psychology University College, London  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,2,3]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1080\/09540261.2019.1643703"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1002\/wps.20858"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.2196\/16730"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.46658\/JBIMES-24-01"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.7870\/cjcmh-2020-018"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cpr.2021.102063"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1348\/147608308X329540"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.1192\/S0007125000297663"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.3389\/fpsyg.2018.01675"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00127-019-01698-7"},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.1111\/ap.12172"},{"key":"e_1_2_11_13_1","doi-asserted-by":"publisher","DOI":"10.2196\/10091"},{"key":"e_1_2_11_14_1","doi-asserted-by":"publisher","DOI":"10.1176\/appi.ps.201300289"},{"key":"e_1_2_11_15_1","doi-asserted-by":"publisher","DOI":"10.1177\/1359104510391860"},{"key":"e_1_2_11_16_1","doi-asserted-by":"publisher","DOI":"10.1093\/schbul\/sbz038"},{"key":"e_1_2_11_17_1","doi-asserted-by":"publisher","DOI":"10.1111\/eip.13497"},{"key":"e_1_2_11_18_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10608-012-9460-9"},{"key":"e_1_2_11_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.schres.2010.01.032"},{"key":"e_1_2_11_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijnurstu.2020.103583"},{"key":"e_1_2_11_21_1","doi-asserted-by":"publisher","DOI":"10.1108\/MHRJ-09-2017-0038"},{"key":"e_1_2_11_22_1","doi-asserted-by":"publisher","DOI":"10.1002\/wps.20306"},{"key":"e_1_2_11_23_1","doi-asserted-by":"publisher","DOI":"10.1176\/appi.ps.201200570"},{"key":"e_1_2_11_24_1","doi-asserted-by":"publisher","DOI":"10.1016\/B978-0-12-815012-2.00016-X"},{"issue":"5","key":"e_1_2_11_25_1","first-page":"527","article-title":"The therapeutic relationship in CBT for psychosis: Client, therapist and therapy factors","volume":"37","author":"Evans\u2010Jones C.","year":"2009","journal-title":"Behaviour Research and Therapy"},{"key":"e_1_2_11_26_1","unstructured":"Fitzsimmons M.(2019).Understanding disengagement from Early Intervention in Psychosis Services. Perspectives from service users and staff. The University of Manchester (United Kingdom)."},{"issue":"1","key":"e_1_2_11_27_1","first-page":"25","article-title":"Improving reporting of meta\u2010ethnography: The eMERGE reporting guidance","volume":"19","author":"France E. F.","year":"2019","journal-title":"BioMed Research International"},{"key":"e_1_2_11_28_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.eurpsy.2016.11.010"},{"key":"e_1_2_11_29_1","doi-asserted-by":"publisher","DOI":"10.3390\/ijerph18147239"},{"key":"e_1_2_11_30_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.2044-8341.2011.02043.x"},{"key":"e_1_2_11_31_1","doi-asserted-by":"publisher","DOI":"10.1093\/pan\/mps061"},{"key":"e_1_2_11_32_1","doi-asserted-by":"publisher","DOI":"10.1111\/papt.12084"},{"key":"e_1_2_11_33_1","doi-asserted-by":"publisher","DOI":"10.1177\/0022022115575737"},{"key":"e_1_2_11_34_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11126-014-9332-4"},{"key":"e_1_2_11_35_1","doi-asserted-by":"publisher","DOI":"10.1017\/CBO9781139168489"},{"key":"e_1_2_11_36_1","doi-asserted-by":"publisher","DOI":"10.1111\/bjc.12059"},{"key":"e_1_2_11_37_1","doi-asserted-by":"publisher","DOI":"10.1017\/S1352465812000495"},{"key":"e_1_2_11_38_1","doi-asserted-by":"publisher","DOI":"10.1093\/schbul\/sbp046"},{"key":"e_1_2_11_39_1","unstructured":"Ltd QSRIP. (n.d.).No Title. Available from.https:\/\/www.qsrinternational.com\/nvivo\u2010qualitative\u2010data\u2010analysis\u2010software\/home"},{"key":"e_1_2_11_40_1","doi-asserted-by":"publisher","DOI":"10.1176\/appi.ps.201400475"},{"key":"e_1_2_11_41_1","doi-asserted-by":"publisher","DOI":"10.1097\/NMD.0b013e31828e0e19"},{"key":"e_1_2_11_42_1","doi-asserted-by":"publisher","DOI":"10.53841\/bpscpr.2018.33.2.4"},{"key":"e_1_2_11_43_1","doi-asserted-by":"publisher","DOI":"10.1001\/archpsyc.62.9.975"},{"key":"e_1_2_11_44_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pmed.1000097"},{"key":"e_1_2_11_45_1","doi-asserted-by":"publisher","DOI":"10.1093\/schbul\/sbp118"},{"key":"e_1_2_11_46_1","unstructured":"National Institute of Clinical Excellence. (2014).Psychosis and schizophrenia in adults: prevention and management [CG178] [Internet]. Available from.https:\/\/www.nice.org.uk\/Guidance\/CG178"},{"key":"e_1_2_11_47_1","doi-asserted-by":"publisher","DOI":"10.1348\/147608306X110148"},{"key":"e_1_2_11_48_1","doi-asserted-by":"publisher","DOI":"10.3109\/01612840.2013.837992"},{"key":"e_1_2_11_49_1","doi-asserted-by":"publisher","DOI":"10.1136\/eb-2015-102054"},{"key":"e_1_2_11_50_1","doi-asserted-by":"publisher","DOI":"10.4135\/9781412985000"},{"key":"e_1_2_11_51_1","doi-asserted-by":"publisher","DOI":"10.1017\/9781009006781"},{"key":"e_1_2_11_52_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00127-008-0476-0"},{"key":"e_1_2_11_53_1","doi-asserted-by":"publisher","DOI":"10.1111\/eip.12905"},{"key":"e_1_2_11_54_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.schres.2021.08.023"},{"key":"e_1_2_11_55_1","doi-asserted-by":"publisher","DOI":"10.1108\/MHSI-08-2018-0028"},{"key":"e_1_2_11_56_1","unstructured":"Programme cas. (2023).Casp qualitative research checklist. Available from.https:\/\/casp\u2010uk.net\/casp\u2010tools\u2010checklists\/qualitative\u2010studies\u2010checklist\/"},{"key":"e_1_2_11_57_1","volume-title":"R: A language and environment for statistical computing","author":"R Core Team","year":"2021"},{"key":"e_1_2_11_58_1","doi-asserted-by":"publisher","DOI":"10.4135\/9781452226569"},{"issue":"1","key":"e_1_2_11_59_1","article-title":"Rates and predictors of disengagement and strength of engagement for people with a first episode of psychosis using early intervention services: A systematic review of predictors and meta\u2010analysis of disengagement rates","volume":"3","author":"Robson E.","year":"2022","journal-title":"Schizophrenia Bulletin Open Access"},{"issue":"1","key":"e_1_2_11_60_1","first-page":"1","article-title":"Meta\u2010ethnography in healthcare research: A guide to using a meta\u2010ethnographic approach for literature synthesis","volume":"21","author":"Sattar R.","year":"2021","journal-title":"BioMed Research International"},{"key":"e_1_2_11_61_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11126-015-9348-4"},{"key":"e_1_2_11_62_1","doi-asserted-by":"publisher","DOI":"10.1002\/anzf.1407"},{"key":"e_1_2_11_63_1","doi-asserted-by":"publisher","DOI":"10.1111\/papt.12531"},{"key":"e_1_2_11_64_1","doi-asserted-by":"publisher","DOI":"10.1177\/1049732312468337"},{"key":"e_1_2_11_65_1","doi-asserted-by":"publisher","DOI":"10.1177\/1098214016673902"},{"key":"e_1_2_11_66_1","doi-asserted-by":"publisher","DOI":"10.1192\/j.eurpsy.2023.2465"},{"key":"e_1_2_11_67_1","doi-asserted-by":"publisher","DOI":"10.3389\/fpsyt.2020.00565"},{"key":"e_1_2_11_68_1","doi-asserted-by":"publisher","DOI":"10.1080\/17522439.2018.1502341"},{"key":"e_1_2_11_69_1","doi-asserted-by":"publisher","DOI":"10.1176\/appi.ajp.163.3.365"},{"key":"e_1_2_11_70_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1751-7893.2007.00039.x"},{"key":"e_1_2_11_71_1","doi-asserted-by":"publisher","DOI":"10.2196\/17570"},{"key":"e_1_2_11_72_1","doi-asserted-by":"publisher","DOI":"10.1177\/1525822X09332633"},{"key":"e_1_2_11_73_1","doi-asserted-by":"publisher","DOI":"10.1017\/S1352465813000970"}],"container-title":["Psychology and Psychotherapy: Theory, Research and Practice"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/bpspsychub.onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/papt.12576","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,11,4]],"date-time":"2025-11-04T17:33:18Z","timestamp":1762277598000},"score":1,"resource":{"primary":{"URL":"https:\/\/bpspsychub.onlinelibrary.wiley.com\/doi\/10.1111\/papt.12576"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,2,3]]},"references-count":72,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2025,6]]}},"alternative-id":["10.1111\/papt.12576"],"URL":"https:\/\/doi.org\/10.1111\/papt.12576","archive":["Portico"],"relation":{"has-preprint":[{"id-type":"doi","id":"10.31219\/osf.io\/fbxeg_v1","asserted-by":"object"}]},"ISSN":["1476-0835","2044-8341"],"issn-type":[{"value":"1476-0835","type":"print"},{"value":"2044-8341","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,2,3]]},"assertion":[{"value":"2024-11-25","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-01-17","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-02-03","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}