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People with experiences conceptualised as psychosis often experience trauma in their life. Psychologically traumatic experiences can happen when a person is a child, through symptoms, or due to bad healthcare experiences. Some people also report positive psychological changes that happen follow trauma. This is called posttraumatic growth.

The Evaluating Positive Changes in psychosis (EPOCH) Study aims to develop knowledge into how posttraumatic growth occurs in experiences conceptualised as psychosis and develop a new digital intervention to support this.


The aims of the EPOCH Study are:

  1. To validate the PROSPERO conceptual framework
  2. Develop a change model for how posttraumatic growth occurs in psychosis
  3. Modify two existing interventions to develop a new digital intervention
  4. Develop and deliver training for peer support workers in the moderation of online discussion forums
  5. Evaluate the usability and acceptability of the intervention
  6. Establish trial parameters and optimise the intervention

Using a mixed-methods approach, we will develop theoretical knowledge by using interviews and longitudinal surveys, which will give us understanding of the processes and mechanisms to characterise how positive changes occur over time. The intervention will be developed considering the developed theoretical knowledge and by working in partnership with the EPOCH Lived Experience Advisory Panel.

Who is involved?

The EPOCH Study is led by Fiona Ng and is guided by an International Advisory Board, the EPOCH Lived Experience Advisory Panel, and a Trial Steering Committee (Chair: Prof Bryn Lloyd-Evans, UCL). The study is hosted by the Recovery Research Team, Institute of Mental Health, and the School of Health Sciences at the University of Nottingham.

International Advisory Board 

Professor Pim Cuijpers (VU University Amsterdam, The Netherlands)

Professor Paul Lysaker (Indiana University, USA)

Professor Frank Penedo (University of Miami, USA)

Professor David Roe (Haifa University, Israel)

Professor Philip Yanos (City University of New York, USA)

Dr Stefan Rennick-Egglestone (University of Nottingham)

Dr Gerald Jordan (University of Birmingham


EPOCH is funded by a National Institute of Health and Care Research Advanced Fellowship (NIHR302218) and a University of Nottingham Anne McLaren Fellowship (RIS6676056), running between 2022-2027.


    Conceptualisation of posttraumatic growth in experiences of psychosis

    We conducted a systematic review and narrative synthesis to understand the correlates, mediators and facilitators of posttraumatic growth in psychosis based on a pre-registered review protocol.

    We have also investigated the experience of mental health service users in an interview study in Egypt and in a longitudinal qualitative study with young people with experience of first episode psychosis in Canada.

      Knowledge Exchange Activities

      We have given webinars giving an overview of what positive change and posttraumatic growth looks like in psychosis and how clinicians can facilitate positive change.

        Opportunity to take part in the EPOCH Study

        We are currently looking for adults with experiences conceptualised as psychosis to take part in a one-hour interview to talk about the positive changes and meaning they have made as a result of their experience of psychosis. We define ‘psychosis’ on a dimension – including diagnostic and non-diagnostic understandings (e.g. spiritual emergency, voice hearing).

        The EPOCH Study is looking to develop understanding as how positive changes or posttraumatic growth occurs in experiences conceptualised as psychosis. Posttraumatic growth is defined as the positive changes that occur following an emotional struggle with major life event or trauma.

        We are currently looking to talk to adults (18+), living in England, who have experiences conceptualised as ‘psychosis’, and are interested in talking to us about their experiences of positive change and how they have made meaning from their experiences of psychosis. Individuals will take part in an one hour interview (via Teams or phone) and reimbursed £20. Interviews will occur in January 2023.

        If you are interested in taking part, please follow this link for more information and to sign up here.


          For more information about the EPOCH study please contact fiona.ng@nottingham.ac.uk