A randomised controlled trial of cognitive behaviour therapy for psychosis in a routine clinical service

Abstract

Peters E, Landau S, McCrone P, Cooke M, Fisher P, Steel C, Evans R, Carswell K, Dawson K, Williams S, Howard A, Kuipers E. A randomised controlled trial of cognitive behaviour therapy for psychosis in a routine clinical service. Objective: To evaluate cognitive behaviour therapy for psychosis (CBTp) delivered by non‐expert therapists, using CBT relevant measures. Method: Participants ( N = 74) were randomised into immediate therapy or waiting list control groups. The therapy group was offered 6 months of therapy and followed up 3 months later. The waiting list group received therapy after waiting 9 months (becoming the delayed therapy group). Results: Depression improved in the combined therapy group at both the end of therapy and follow‐up. Other significant effects were found in only one of the two therapy groups (positive symptoms; cognitive flexibility; uncontrollability of thoughts) or one of the two time points (end of therapy: general symptoms, anxiety, suicidal ideation, social functioning, resistance to voices; follow‐up: power beliefs about voices, negative symptoms). There was no difference in costs between the groups. Conclusion: The only robust improvement was in depression. Nevertheless, there were further encouraging but modest improvements in both emotional and cognitive variables, in addition to psychotic symptoms.