scholarly journals Randomised controlled trial of cognitive-behavioural therapy in early schizophrenia: Acute-phase outcomes

2002 ◽  
Vol 181 (S43) ◽  
pp. s91-s97 ◽  
Author(s):  
Shôn Lewis ◽  
Nicholas Tarrier ◽  
Gillian Haddock ◽  
Richard Bentall ◽  
Peter Kinderman ◽  
...  
Keyword(s):  
Cognitive Behavioural Therapy ◽  
Controlled Trial ◽  
Behavioural Therapy ◽  
Routine Care ◽  
Psychotic Symptoms ◽  
Cognitive Behavioural ◽  
Scale Scores ◽  
Supportive Counselling ◽  
Randomised Controlled ◽  
Early Schizophrenia

BackgroundCognitive–behavioural therapy (CBT) improves persistent psychotic symptoms.AimsTo test the effectiveness of added CBT in accelerating remission from acute psychotic symptoms in early schizophrenia.MethodA 5-week CBT programme plus routine care was compared with supportive counselling plus routine care and routine care alone in a multi-centre trial randomising 315 people with DSM–IV schizophrenia and related disorders in their first (83%) or second acute admission. Outcome assessments were blinded.ResultsLinear regression over 70 days showed predicted trends towards faster improvement in the CBT group. Uncorrected univariate comparisons showed significant benefits at 4 but not 6 weeks for CBTv. routine care alone on Positive and Negative Syndrome Scale total and positive sub-scale scores and delusion score and benefits v. supportive counselling for auditory hallucinations score.ConclusionsCBT shows transient advantages over routine care alone or supportive counselling in speeding remission from acute symptoms in early schizophrenia.

London–East Anglia randomised controlled trial of cognitive–behavioural therapy for psychosis

1997 ◽  
Vol 171 (4) ◽  
pp. 319-327 ◽  
Author(s):  
Elizabeth Kuipers ◽  
Philippa Garety ◽  
David Fowler ◽  
Graham Dunn ◽  
Paul Bebbington ◽  
...  
Keyword(s):  
Randomised Controlled Trial ◽  
Cognitive Behavioural Therapy ◽  
Standard Care ◽  
Controlled Trial ◽  
Behavioural Therapy ◽  
Psychotic Symptoms ◽  
Control Group ◽  
Improve Outcome ◽  
Cognitive Behavioural ◽  
Randomised Controlled

BackgroundA series of small, mainly uncontrolled, studies have suggested that techniques adapted from cognitive–behavioural therapy (CBT) for depression can improve outcome in psychosis, but no large randomised controlled trial of intensive treatment for medication-resistant symptoms of psychosis has previously been published.MethodSixty participants who each had at least one positive and distressing symptom of psychosis that was medication-resistant were randomly allocated between a CBT and standard care condition (n=28) and a standard care only control condition (n=32). Therapy was individualised, and lasted for nine months. Multiple assessments of outcome were used.ResultsOver nine months, improvement was significant only in the treatment group, who showed a 25% reduction on the BPRS. No other clinical, symptomatic or functioning measure changed significantly. Participants had a low drop-out rate from therapy (11%), and expressed high levels of satisfaction with treatment (80%). Fifty per cent of the CBT group were treatment responders (one person became worse), compared with 31% of the control group (three people became worse and another committed suicide)ConclusionsCBT for psychosis can improve overall symptomatology. The findings provide evidence that even a refractory group of clients with a long history of psychosis can engage in talking about psychotic symptoms and their meaning, and this can improve outcome.

Durability of the effects of cognitive–behavioural therapy in the treatment of chronic schizophrenia: 12-month follow-up

1999 ◽  
Vol 174 (6) ◽  
pp. 500-504 ◽  
Author(s):  
Nicholas Tarrier ◽  
Anja Witttkowskj ◽  
Caroline Kinney ◽  
Eilis McCarthy ◽  
Juue Morris ◽  
...  
Keyword(s):  
Cognitive Behavioural Therapy ◽  
Negative Symptoms ◽  
Chronic Schizophrenia ◽  
Behavioural Therapy ◽  
Routine Care ◽  
Psychotic Symptoms ◽  
Cognitive Behavioural ◽  
Supportive Counselling ◽  
One Year

BackgroundPersistent drug-resistant psychotic symptoms are a pervasive problem in the treatment of schizophrenia.AimsTo evaluate the durability of the treatment effects of cognitive–behavioural therapy for chronic schizophrenia one year after treatment termination.MethodA comparison of clinical outcomes was made at one-year follow-up from a randomised trial of cognitive–behavioural therapy, supportive counselling and routine care alone in the treatment of chronic schizophrenia.ResultsSeventy out of the 72 patients (97%) who completed treatment were assessed at follow-up. There were significant differences between the three groups when positive and negative symptoms were analysed by means of ANCOVAs. Between-group comparisons indicated significant differences between cognitive–behavioural therapy and routine care at follow-up for positive symptoms. There was a trend towards significance for both cognitive–behavioural therapy and supportive counselling to be superior to routine care alone on negative symptoms.ConclusionsAt 12-month follow-up the significant advantage of cognitive– behavioural therapy compared to routine care alone remained.

scholarly journals Increasing access to cognitive–behavioural therapy for patients with psychosis by evaluating the feasibility of a randomised controlled trial of brief, targeted cognitive–behavioural therapy for distressing voices delivered by assistant psychologists: the GiVE2 trial

BJPsych Open ◽  
2021 ◽  
Vol 7 (5) ◽  
Author(s):  
Mark Hayward ◽  
Katherine Berry ◽  
Stephen Bremner ◽  
Anna-Marie Jones ◽  
Sam Robertson ◽  
...  
Keyword(s):  
Randomised Controlled Trial ◽  
Cognitive Behavioural Therapy ◽  
Controlled Trial ◽  
Behavioural Therapy ◽  
Post Treatment ◽  
Treatment As Usual ◽  
Cognitive Behavioural ◽  
Supportive Counselling ◽  
Randomised Controlled

Background Cognitive–behavioural therapy (CBT) is recommended for all patients with psychosis, but is offered to only a minority. This is attributable, in part, to the resource-intensive nature of CBT for psychosis. Responses have included the development of CBT for psychosis in brief and targeted formats, and its delivery by briefly trained therapists. This study explored a combination of these responses by investigating a brief, CBT-informed intervention targeted at distressing voices (the GiVE intervention) administered by a briefly trained workforce of assistant psychologists. Aims To explore the feasibility of conducting a randomised controlled trial to evaluate the clinical and cost-effectiveness of the GiVE intervention when delivered by assistant psychologists to patients with psychosis. Method This was a three-arm, feasibility, randomised controlled trial comparing the GiVE intervention, a supportive counselling intervention and treatment as usual, recruiting across two sites, with 1:1:1 allocation and blind post-treatment and follow-up assessments. Results Feasibility outcomes were favourable with regard to the recruitment and retention of participants and the adherence of assistant psychologists to therapy and supervision protocols. For the candidate primary outcomes, estimated effects were in favour of GiVE compared with supportive counselling and treatment as usual at post-treatment. At follow-up, estimated effects were in favour of supportive counselling compared with GiVE and treatment as usual, and GiVE compared with treatment as usual. Conclusions A definitive trial of the GiVE intervention, delivered by assistant psychologists, is feasible. Adaptations to the GiVE intervention and the design of any future trials may be necessary.

scholarly journals Digital cognitive–behavioural therapy for insomnia compared with digital patient education about insomnia in individuals referred to secondary mental health services in Norway: protocol for a multicentre randomised controlled trial

BMJ Open ◽  
2021 ◽  
Vol 11 (6) ◽  
pp. e050661
Author(s):  
Håvard Kallestad ◽  
Simen Saksvik ◽  
Øystein Vedaa ◽  
Knut Langsrud ◽  
Gunnar Morken ◽  
...  
Keyword(s):  
Mental Health ◽  
Randomised Controlled Trial ◽  
Patient Education ◽  
Cognitive Behavioural Therapy ◽  
Controlled Trial ◽  
Behavioural Therapy ◽  
Group Differences ◽  
Post Intervention ◽  
Cognitive Behavioural ◽  
Randomised Controlled

IntroductionInsomnia is highly prevalent in outpatients receiving treatment for mental disorders. Cognitive–behavioural therapy for insomnia (CBT-I) is a recommended first-line intervention. However, access is limited and most patients with insomnia who are receiving mental healthcare services are treated using medication. This multicentre randomised controlled trial (RCT) examines additional benefits of a digital adaptation of CBT-I (dCBT-I), compared with an online control intervention of patient education about insomnia (PE), in individuals referred to secondary mental health clinics.Methods and analysisA parallel group, superiority RCT with a target sample of 800 participants recruited from treatment waiting lists at Norwegian psychiatric services. Individuals awaiting treatment will receive an invitation to the RCT, with potential participants undertaking online screening and consent procedures. Eligible outpatients will be randomised to dCBT-I or PE in a 1:1 ratio. Assessments will be performed at baseline, 9 weeks after completion of baseline assessments (post-intervention assessment), 33 weeks after baseline (6 months after the post-intervention assessment) and 61 weeks after baseline (12 months after the post-intervention assessment). The primary outcome is between-group difference in insomnia severity 9 weeks after baseline. Secondary outcomes include between-group differences in levels of psychopathology, and measures of health and functioning 9 weeks after baseline. Additionally, we will test between-group differences at 6-month and 12-month follow-up, and examine any negative effects of the intervention, any changes in mental health resource use, and/or in functioning and prescription of medications across the duration of the study. Other exploratory analyses are planned.Ethics and disseminationThe study protocol has been approved by the Regional Committee for Medical and Health Research Ethics in Norway (Ref: 125068). Findings from the RCT will be disseminated via peer-reviewed publications, conference presentations, and advocacy and stakeholder groups. Exploratory analyses, including potential mediators and moderators, will be reported separately from main outcomes.Trial registration numberClinicalTrials.gov Registry (NCT04621643); Pre-results.

scholarly journals Influence of age on outcome of psychological treatments in first-episode psychosis

2006 ◽  
Vol 188 (3) ◽  
pp. 250-254 ◽  
Author(s):  
Gillian Haddock ◽  
Shôn Lewis ◽  
Richard Bentall ◽  
Graham Dunn ◽  
Richard Drake ◽  
...  
Keyword(s):  
Controlled Trial ◽  
Behavioural Therapy ◽  
First Episode ◽  
Treatment As Usual ◽  
Psychological Treatments ◽  
Treatment Providers ◽  
Cognitive Behavioural ◽  
Episode Psychosis ◽  
Supportive Counselling ◽  
Randomised Controlled

BackgroundPsychological treatments have been shown to be effective in patients with psychosis. However, the studies published to date have included participants across wide age ranges, so few conclusions can be reached about the effectiveness of such treatments in relation to age.AimsTo evaluate outcomes by age in a randomised controlled trial designed to evaluate the effectiveness of cognitive-behavioural therapy (CBT), supportive counselling and treatment as usual.MethodOutcomes were evaluated in terms of symptoms, social functioning, insight and therapeutic alliance according to age at 3- and 18-month follow-up.ResultsYounger participants responded better to supportive counselling than to treatment as usual and CBTover 3 months. Older participants responded better to CBT than to supportive counselling over 18 months. Younger participants showed a greater increase in insight after CBT compared with treatment as usual and supportive counselling, and were more difficult to engage in therapy.ConclusionsYoung people may have different needs with regard to engagement in psychological treatments. Treatment providers need to take age-specific factors into account.

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