Enhancing the quality of interactions between parents with psychosis and their young children: a feasibility randomised controlled trial of video feedback
Psychosis
Video Interaction Guidance (VIG): VIG is a brief, strengths-based video feedback intervention that uses videotaped interactions of the parent and child to enhance parental responsiveness to the child’s cues. The VIG therapist films parent-child interactions for 5 minutes and then edits the footage to produce three short video clips (up to 30 seconds) of successful interaction that link to the parent’s goals. In the subsequent ‘shared review’ session, the parent and VIG therapist review the selected clips together. Seeing the videos with the therapist allows the parent to build on moments of positive interaction with their child. One cycle of VIG involves filming (session 1), editing (between sessions), and reviewing video clips (session 2). Parents will receive an introductory session, 3 cycles of VIG (one cycle = two sessions, over 2-3 weeks), and a review session. The intervention will be delivered over 8-10 weeks. Sessions last 45-60 minutes and are delivered in the parent’s home or the clinic. Usual Care: All participants will continue to receive usual care from their treating team. Usual care includes care-coordination, psychiatric review, medication, psychological therapy, family therapy and carer support (for the patient’s caregivers), physical health monitoring, peer support, and, in perinatal teams, parenting skills support. We will not ask referrers or clinicians to withhold any treatment offered as part of usual care in either trial arm.
Current inclusion criteria as of 20/07/2026: Parent: 1. Patient of mental health services (at the time of referral to the trial) 2. A clinical diagnosis of schizophrenia spectrum psychosis (non-affective psychosis) (ICD 10 codes F20–29) or bipolar disorder (F31) with psychotic symptoms (affective psychosis) 3. Caregiving responsibilities for child aged 2-48 months 4. Able to speak English or, if not, willing to involve an interpreter to engage in the trial 5. Willing and able to give informed consent Child: 1. Aged between 2 and 48 months at the time of the parent's referral to the trial 2. In regular contact with the participating parent 3. The child’s parent or legal guardian has provided informed consent for their participation in the study procedures Parent qualitative study: 1. Consent to have interviews audio recorded 2. Participation in the study (n = 5); randomised to the intervention arm and having received at least one cycle of VIG (n = 10) Clinician qualitative study: 1. Consent to have interviews audio recorded 2. Experience of either delivering VIG to study participants, or referring a parent to the study, or working with parents with psychosis and young children in the recruiting Trusts Previous inclusion criteria: Parent: 1. Patient of mental health services (at the time of referral to the trial) 2. A clinical diagnosis of schizophrenia spectrum psychosis (non-affective psychosis) (ICD 10 codes F20–29) or bipolar disorder (F31) with psychotic symptoms (affective psychosis) 3. Caregiving responsibilities for child aged 2-36 months 4. Able to speak English or, if not, willing to involve an interpreter to engage in the trial 5. Willing and able to give informed consent Child: 1. Aged between 2 and 36 months at the time of the parent's referral to the trial 2. In regular contact with the participating parent 3. The child’s parent or legal guardian has provided informed consent for their participation in the study procedures Parent qualitative study
Parent: 1. A co-parent is participating in the trial 2. The parent is engaged in another parenting intervention 3. The eligible parent has psychotic symptoms or cognitive difficulties or substance misuse problems that are sufficiently severe to prevent them engaging with the intervention or completing study measures 4. Contact between the parent and child is not permitted by social services 5. Any other factor (for example, current active suicidal plans) which, in the judgement of the investigator, would preclude the participant from providing informed consent or from safely engaging with the trial procedures. Child: 1. Contact with the participating parent is prohibited by social services or a court order 2. The child is already enrolled in another parenting study 3. A sibling is participating in the trial