Managing unusual sensory experiences in at-risk mental state for psychosis in England:A parallel group, single-blind, randomised controlled feasibility trial

Young people at risk of psychosis often present to services with unusual sensory experiences (USE). Managing Unusual Sensory Experiences (MUSE) is a digital intervention that therapists can use with clients to support better understanding of these experiences and how to manage them. This study aimed to test the feasibility of delivering MUSE within a RCT design. We conducted a randomised, single-blind, feasibility study of MUSE + Treatment as Usual (TAU), compared to TAU, for individuals experiencing USE in At-Risk Mental State (ARMS) services across two mental health trusts in England. Assessments were conducted at baseline, 12 weeks (post-treatment), and 20 weeks (follow-up). Ninety-three people were randomised (47 to TAU and 46 to MUSE+TAU). 79 % of participants completed the primary outcome measures at the primary timepoint (post-treatment). For the primary outcomes, the functioning (SOFAS) score at 12 weeks favoured MUSE+TAU (SOFAS adjusted mean difference 4·19 [95 % CI:10·22 to 1·85] with a Cohen's d of -0·28 [95 % CI:0·68 to 0·12]) and further improved at 20 weeks (adjusted mean difference -5·33 [95 % CI:11·65 to 1·0]; Cohen's d -0·35 [95 % CI:0·77 to 0·07]). The other primary outcome measure (PSYRATS-AH) explored impact on USE and found no difference at 12 weeks (mean adjusted difference 0·01 [95 % CI:4·88 to 4·87], Cohen's d 0·00 [95 % CI:0·48 to 0·48]), but slightly favoured TAU at 20 weeks (adjusted mean difference -1·43 [95 % CI:6·53 to 3·66], Cohen's d -0·14 [95 % CI:0·64 to 0·36]). MUSE is a promising intervention for therapists to use in support of individuals at risk of psychosis.