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Bio

Bio


Melanie Lean, Clin.Psych.D. is a post-doctoral research fellow in the INSPIRE clinic. Trained at University College London, Dr Lean is competent in multiple therapeutic modalities, namely Cognitive Behavioural Therapy (CBT) (including CBT for psychosis), Acceptance and Commitment Therapy (ACT) and Systemic Family Therapy. She has experience working in co-produced services in the UK at the mental health charity, MIND in Camden, including co-facilitating Hearing Voices and Voice Collective groups to support young people who hear, see or sense things that other?s don?t. Dr Lean has over 15 years? experience in clinical research, nine of those in mental health working across a range of settings and populations. She has specialized knowledge in self-management and peer support interventions for people with severe mental illness and has experience working alongside service user researchers in the evaluation and delivery of study interventions.

Clinical Focus


  • Clinical Psychology

Academic Appointments


  • Clinical Instructor, Psychiatry and Behavioral Sciences

Professional Education


  • Professional Education: University College London (2017) UK
  • DClinPsy, University College London (UCL), Clinical Psychology (2017)

Publications

All Publications


  • Pilot study of a group worry intervention for recent onset psychosis COGNITIVE BEHAVIOUR THERAPIST Mackintosh, T., Lean, M., Hardy, K. 2021; 14
  • Training early psychosis community clinicians in CBT for psychosis: Implementation and feasibility. Early intervention in psychiatry Hardy, K. V., Espil, F. M., Smith, C. L., Furuzawa, A., Lean, M., Zhao, Z., Godzikovskaya, J., Gilbert, A., Loewy, R. L. 2020

    Abstract

    OBJECTIVE: Cognitive behavioural therapy (CBT) has demonstrated efficacy for treating of psychotic symptoms and is recommended as an evidence-based practice (EBP) in early psychosis services. Despite this recommendation, there is limited information about the feasibility of training community clinicians, working in an early psychosis service, to competence in the delivery of this intervention.METHOD: Fifty clinicians working in an early psychosis service across five programs in Northern California were trained in CBT for psychosis (CBTp) between 2010 and 2014. Following the training, clinicians attended weekly group consultation and submitted taped sessions for review. Tapes were rated for competency using the Cognitive Therapy Scale-Revised (CTS-R). Clinicians who achieved competence were engaged in a train-the-trainer model to support ongoing sustainability of the training program.RESULTS: Data from 40 clinicians were reviewed for achievement of competence. Over the training period 18 clinicians achieved competence while 20 clinicians left the service before achieving competence and 12 were still in the process of achieving competence at the point of data analysis. It took on average 54weeks (range 17-130weeks) and an average of six tape reviews (range 3-18) to train clinicians to competency.CONCLUSIONS: Community clinicians working in an early psychosis program can be trained to competence in CBTp following an initial didactic period and ongoing weekly group consultation, although staff turnover hindered implementation. Challenges and opportunities for future implementation in community sites are presented in the context of further expansion of early psychosis services in the United States.

    View details for DOI 10.1111/eip.13010

    View details for PubMedID 32583602

  • Self-management interventions for people with severe mental illness: systematic review and meta-analysis BRITISH JOURNAL OF PSYCHIATRY Lean, M., Fornells-Ambrojo, M., Milton, A., Lloyd-Evans, B., Harrison-Stewart, B., Yesufu-Udechuku, A., Kendall, T., Johnson, S. 2019; 214 (5): 260?68

    Abstract

    Self-management is intended to empower individuals in their recovery by providing the skills and confidence they need to take active steps in recognising and managing their own health problems. Evidence supports such interventions in a range of long-term physical health conditions, but a recent systematic synthesis is not available for people with severe mental health problems.AimsTo evaluate the effectiveness of self-management interventions for adults with severe mental illness (SMI).A systematic review of randomised controlled trials was conducted. A meta-analysis of symptomatic, relapse, recovery, functioning and quality of life outcomes was conducted, using RevMan.A total of 37 trials were included with 5790 participants. From the meta-analysis, self-management interventions conferred benefits in terms of reducing symptoms and length of admission, and improving functioning and quality of life both at the end of treatment and at follow-up. Overall the effect size was small to medium. The evidence for self-management interventions on readmissions was mixed. However, self-management did have a significant effect compared with control on subjective measures of recovery such as hope and empowerment at follow-up, and self-rated recovery and self-efficacy at both time points.There is evidence that the provision of self-management interventions alongside standard care improves outcomes for people with SMI. Self-management interventions should form part of the standard package of care provided to people with SMI and should be prioritised in guidelines: research on best methods of implementing such interventions in routine practice is needed.Declaration of interestsNone.

    View details for DOI 10.1192/bjp.2019.54

    View details for Web of Science ID 000465581400004

    View details for PubMedID 30898177

    View details for PubMedCentralID PMC6499726

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