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Video self-observation: a means of improving insight in psychosis

  • Sitara Vikram (a1), Nishi Yarger (a2), Adrian Coxell (a3) and Michael Maier (a4)
Abstract
Aims and Method

To improve the level of insight (measured using standardised instruments) using a video interview and self-observation. Changes in levels of insight were measured using the Schedule for Assessing Insight (SAI) at the time of admission, at the time of discharge (both prior to and following the viewing of the videotape) and at follow-up a few months later.

Results

The comparison of the SAI scores indicated a significant improvement in insight at the time of discharge (P < 0.005), with a further significant improvement after watching the video (P < 0.006). This appeared to be sustained at 3- to 6-month follow-up.

Clinical Implications

Video self-observation is a simple, inexpensive procedure that can be used to improve insight in psychosis. This study provides further support for the clinical utility of video self-observation in improving client's insight.

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Copyright
This is an Open Access article, distributed under the terms of the Creative Commons Attribution (CC-BY) license (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.
References
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BJPsych Bulletin
  • ISSN: 0955-6036
  • EISSN: 1472-1473
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Video self-observation: a means of improving insight in psychosis

  • Sitara Vikram (a1), Nishi Yarger (a2), Adrian Coxell (a3) and Michael Maier (a4)
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eLetters

A Balancing Act

Vishweshwari Bhadravathi, Specialist Registrar in Child and Adolescent Psychiatry, Solihull CAMHS
13 September 2008

It was interesting to read the article 'Video self-observation: a means of improving insight in psychosis,'Sep08.

Using videos for training purposes (interviewing clients, teaching sessions etc) are well known in clinical practice. Such techniques are widely used in various therapeutic settings as well, especially Systemic Therapy.

The technique per se could be used for any clinical presentation withpresumably a similar positive impact on insight into diagnosis and treatment. The caution that needs to be seriously considered is, as the authors mention, the distress and embarrassment caused to the clients while watching themselves during a psychotic/manic phase.

A number of patients, after recovery, describe a feeling of shame andguilt about destroying property, physical promiscuity etc exhibited duringa manic phase. It would be vital to look at the impact of such sort of visual insight on their future self esteem.

Also, from a clinical governance point of view, a lot of strict regulations need to be put in place in terms of storing, viewing and sharing this material - especially in today's age of YouTube culture.
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Conflict of interest: None Declared

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