Hostname: page-component-586b7cd67f-t8hqh Total loading time: 0 Render date: 2024-11-24T04:32:24.609Z Has data issue: false hasContentIssue false
  • English
  • Français

A Feasibility Study of the Translation of Cognitive Behaviour Therapy for Psychosis into an Australian Adult Mental Health Clinical Setting

Published online by Cambridge University Press:  03 March 2020

Lee Beames ,
Esben Strodl ,
Frances Dark ,
Jennifer Wilson ,
Judith Sheridan  and
Nicholas Kerswell
Lee Beames*
Affiliation:
Metro North Mental Health Services, Chermside, Queensland, Australia
Esben Strodl
Affiliation:
School of Psychology and Counselling, Queensland University of Technology, Kelvin Grove, Queensland, Australia
Frances Dark
Affiliation:
Metro South Mental Health Service, Brisbane, Queensland, Australia
Jennifer Wilson
Affiliation:
Private Practice, Brisbane, Queensland, Australia
Judith Sheridan
Affiliation:
School of Psychology and Counselling, Queensland University of Technology, Kelvin Grove, Queensland, Australia
Nicholas Kerswell
Affiliation:
School of Psychology and Counselling, Queensland University of Technology, Kelvin Grove, Queensland, Australia
*
*Corresponding author: Lee Beames, Metro North Mental Health Services, The Prince Charles Hospital, Rode Rd, Chermside, QLD, Australia. Email: [email protected]
Get access

Abstract

There is evidence that Cognitive Behaviour Therapy for Psychosis (CBTp) is an effective intervention for reducing psychotic symptoms. The recently updated Royal Australian and New Zealand College of Psychiatrists clinical practice guidelines (RANZCP CPG) recommend CBTp for the therapeutic management of schizophrenia and related disorders. Translational research is required to examine how well CBTp can be applied into public mental health services. This feasibility study aimed to provide preliminary evidence on how acceptable, implementable, and adaptable individual or group CBTp may be within a public mental health service in Australia. Twenty-seven participants initially agreed to participate in the study with 16 participants being randomised to either group or individual therapy, 11 starting therapy and 7 completing therapy. The intervention involved approximately 20 h of manualised CBTp. Attendance was higher in the individual therapy. Subjective reports indicated that the therapy was acceptable to all completers. Participants who engaged in individual or group CBTp experienced a similar level of reduction in the severity of hallucinations and delusions. Individual CBTp may be a feasible, acceptable, and effective intervention to include in Australian public mental health services. A pilot trial is now required to provide further evidence for and guidance of how best to translate CBTp protocols to Australian mental health services.

Keywords

cognitive behaviour therapy for psychosismental health servicespsychosistranslational research
Type
Standard Paper
Information
Behaviour Change , Volume 37 , Issue 1 , April 2020 , pp. 22 - 32
Copyright
Copyright © The Author(s) 2020. Published by Cambridge University Press

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Addington, J and Lecomte, T (2012). Cognitive behaviour therapy for schizophrenia. F1000 Medicine Reports, 4, 6.CrossRefGoogle Scholar
Albiston, DJ, Francey, SM and Harrigan, SM (1998). Group programmes for recovery from early psychosis. British Journal of Psychiatry, 172, 117–121.CrossRefGoogle ScholarPubMed
Australian Institute of Health and Welfare (2013). Mental health services—in brief 2013. Cat. no. HSE 141. Canberra: AIHW.Google Scholar
Barrowclough, C, Haddock, G, Wykes, T, Beardmore, R, Conrod, P, Craig, T, … Tarrier, N (2010). Integrated motivational interviewing and cognitive behavioural therapy for people with psychosis and comorbid substance misuse: Randomised controlled trial. British Medical Journal, 341, 1–12.CrossRefGoogle ScholarPubMed
Berry, K and Haddock, G (2008). The implementation of the nice guidelines for schizophrenia: Barriers to the implementation of psychological interventions and recommendations for the future. Psychological Psychotherapy, 81, 419–436.CrossRefGoogle ScholarPubMed
Brabban, A, Tai, S and Turkington, D (2009). Predictors of outcome in brief cognitive behavior therapy for schizophrenia. Schizophrenia Bulletin, 35, 859–864.CrossRefGoogle Scholar
Buckingham, W, Burgess, P, Soloman, S, Pirkis, J and Eagar, K (1998). Developing a casemix classification for mental health services: Summary. Canberra: Commonwealth Department of Health and Family Services.Google Scholar
Cather, C, Penn, D, Otto, MW, Yovel, I, Mueser, KT and Goff, D (2005). A pilot study of functional cognitive behavioral therapy (FCBT) for schizophrenia. Schizophrenia Research, 74, 201–209.CrossRefGoogle Scholar
Cornelius, BL, Groothoff, JW, van der Klink, JJ and Brouwer, S (2013). The performance of the K10, K6 and GHQ-12 to screen for present state DSM-IV disorders among disability claimants. BMC Public Health, 13, 1.CrossRefGoogle ScholarPubMed
Dold, M and Leucht, S (2014). Pharmacotherapy of treatment-resistant schizophrenia: A clinical perspective. Evidence-Based Mental Health, 17, 33–37.CrossRefGoogle ScholarPubMed
Duncan, BL, Miller, S, Sparks, JA, Claud, DA, Reynolds, LR, Brown, J and Johnson, L (2003). The session rating scale: Preliminary psychometric properties of a ‘working’ alliance measure. Journal of Brief Therapy, 3, 3–12.Google Scholar
Fowler, DR, Garety, PA and Kuipers, L (1995). Cognitive behaviour therapy for psychosis: Theory and practice. Chichester, New York: Wiley.Google Scholar
Furukawa, TA, Kessler, RC, Slade, T and Andrews, G (2003). The performance of the K6 and K10 screening scales for psychological distress in the Australian National Survey of Mental Health and Well-Being. Psychological Medicine, 33, 357–362.CrossRefGoogle ScholarPubMed
Galletly, C, Castle, D, Dark, F, Humberstone, V, Jablensky, A, Killackey, J, … Tran, N (2016). Royal Australian and New Zealand College of Psychiatrists clinical practice guidelines for the management of schizophrenia and related disorders. Australian and New Zealand Journal of Psychiatry, 50, 410–472.CrossRefGoogle ScholarPubMed
Gaudiano, BA (2006). Is symptomatic improvement in clinical trials of cognitive-behavioural therapy for psychosis clinically significant? Journal of Psychiatric Practice, 12, 11–23.CrossRefGoogle ScholarPubMed
Haddock, G, Mccarron, J, Tarrier, N and Faragher, EB (1999). Scales to measure dimensions of hallucinations and delusions: The Psychotic Symptom Rating Scales (PSYRATS). Psychological Medicine, 29, 879–889.CrossRefGoogle Scholar
Jacobson, NS and Truax, P (1991). Clinical significance: A statistical approach to defining meaningful change in psychotherapy research. Journal of Consulting and Clinical Psychology, 59, 12.CrossRefGoogle ScholarPubMed
Jacobson, NS, Wilson, L and Tupper, C (1988). The clinical significance of treatment gains resulting from exposure-based intervention for agoraphobia: A reanalysis of outcome data. Behavior Therapy, 19, 539–554.CrossRefGoogle Scholar
Kane, JM, Kishimoto, T and Correll, CU (2013). Non-adherence to medication in patients with psychotic disorders: Epidemiology, contributing factors and management strategies. World Psychiatry, 12, 216–226.CrossRefGoogle ScholarPubMed
Kessler, RC, Barker, PR, Colpe, LJ, Epstein, JF, Gfroerer, JC, Hiripi, E, … Zaslavsky, AM (2003). Screening for serious mental illness in the general population. Archives of General Psychiatry, 60, 184–189.CrossRefGoogle ScholarPubMed
Kingdon, DG and Turkington, D (2005). Cognitive therapy of schizophrenia. New York: The Guilford Press.Google Scholar
Kronmüller, KT, Von Bock, A, Grupe, S, Buche, L, Gentner, NC, Rucki, S, … Mundt, C (2011). Psychometric evaluation of the Psychotic Symptom Rating Scales. Comprehensive Psychiatry, 52, 102–108.CrossRefGoogle ScholarPubMed
Lecomte, T, Leclerc, C, Wykes, T and Lecomte, J (2003). Group CBT for clients with a first episode of schizophrenia. Journal of Cognitive Psychotherapy: An International Quarterly, 17, 375–383.CrossRefGoogle Scholar
Lecomte, T, Leclerc, C, Wykes, T, Wallace, CJ, Spide, A and Corbiere, A (2006). Group CBT skills training for first episodes of psychosis: Results of an RCT. Schizophrenia Research, 86, 45.CrossRefGoogle Scholar
Lecomte, T, Spidel, A, Leclerc, C, MacEwan, GW, Greaves, C and Bentall, RP (2008). Predictors and profiles of treatment non-adherence and engagement in services problems in early psychosis. Schizophrenia Research, 102, 295–302.CrossRefGoogle ScholarPubMed
Lehman, AF, Lieberman, JA, Dixon, LB, McGlashan, TH, Miller, AL, Perkins, DO, … Regier, D (2004). Practice guideline for the treatment of patients with schizophrenia, Second Edition. American Journal of Psychiatry, 161, 1–56.Google ScholarPubMed
Michie, S, Pilling, S, Garety, P, Whitty, P, Eccles, MP, Johnston, M and Simmons, J (2007). Difficulties implementing a mental health guideline: An exploratory investigation using psychological theory. Implementation Science, 2, 8–15.CrossRefGoogle ScholarPubMed
Miller, SD, Duncan, B, Brown, J, Sparks, JA and Claud, DA (2003). The Outcome Rating Scale: A preliminary study of the reliability, validity, and feasibility of a brief visual analog measure. Journal of Brief Therapy, 2, 91–100.Google Scholar
Morrison, AP and Barratt, S (2010). What are the components of CBT for psychosis? A Delphi study. Schizophrenia Bulletin, 36, 136–142.CrossRefGoogle ScholarPubMed
Neil, AL, Carr, VJ, Mihalopoulos, C, Mackinnion, A, Lewin, TJ and Morgan, VA (2014). What difference a decade? The costs of psychosis in Australia in 2000 and 2010: Comparative results from the first and second Australian National Surveys of Psychosis. Australian and New Zealand Journal of Psychiatry, 48, 237–248.CrossRefGoogle Scholar
Parker, G, Rosen, A, Emdur, N and Hadzi-Pavlo, D (1991). The life skills profile: Psychometric properties of a measure assessing function and disability in schizophrenia. Acta Psychiatrica Scandinavica, 83, 145–152.CrossRefGoogle Scholar
Penn, DC, Meuser, KT, Tarrier, N, Gloege, A, Cather, C, Serrano, D and Otto, MW (2004). Supportive therapy for schizophrenia: Possible mechanisms and implications for adjunctive psychosocial treatments. Schizophrenia Bulletin, 30, 101–112.CrossRefGoogle ScholarPubMed
Peters, DH, Adam, T, Alonge, O, Agyepong, IA and Tran, N (2014). Republished research: Implementation research: What it is and how to do it: Implementation research is a growing but not well understood field of health research that can contribute to more effective public health and clinical policies and programmes. This article provides a broad definition of implementation research and outlines key principles for how to do it. British Journal of Sports Medicine, 48, 731–736.CrossRefGoogle Scholar
Reynolds, GP (2012). The pharmacogenetics of symptom response to antipsychotic drugs. Psychiatry Investigation, 9, 1–7.CrossRefGoogle ScholarPubMed
Rollinson, R, Smith, B, Steel, C, Jolley, S, Onwumere, J, Garety, PA, … Fowler, D (2008). Measuring adherence in CBT for psychosis: A psychometric analysis of an adherence scale. Behavioural and Cognitive Psychotherapy, 36, 163–178.CrossRefGoogle Scholar
Rosen, A, Hadzi-Pavlovic, D and Parker, G (1989). The Life Skills Profile: A measure assessing function and disability in schizophrenia. Schizophrenia Bulletin, 15, 325–337.CrossRefGoogle Scholar
Rowlands, P (2004). The NICE schizophrenia guidelines: The challenge of implementation. Advances in Psychiatric Treatment, 10, 403–412.CrossRefGoogle Scholar
Saksa, J, Cohen, SJ, Srihari, VH and Woods, SW (2009). Cognitive behaviour therapy for early psychosis: A comprehensive review of individual vs group treatment studies. International Journal of Group Psychotherapy, 59, 357–383.CrossRefGoogle ScholarPubMed
Sensky, T, Turkington, D, Kingdon, D, Scott, JL, Scott, J, Siddle, R, … Barnes, TRE (2000). A randomized controlled trial of cognitive-behavioral therapy for persistent symptoms in schizophrenia resistant to medication. Archives of General Psychiatry, 57, 165–172.CrossRefGoogle ScholarPubMed
Sung, NS, Crowley, WF, Genel, M, Salber, P, Sandy, L, Sherwood, LM, … Rimoin, D (2003). Central challenges facing the National Clinical Research Enterprise. JAMA, 289, 1278–1287.CrossRefGoogle ScholarPubMed
Tarrier, N (2005). Cognitive behaviour therapy for schizophrenia — A review of development, evidence and implementation. Psychotherapy and Psychosomatics, 74, 136–144.CrossRefGoogle ScholarPubMed
Tashiro, T and Mortensen, L (2006). Translational research: How social psychology can improve psychotherapy. American Psychologist, 61, 959–966.CrossRefGoogle ScholarPubMed
Thornicroft, G and Tansella, M (2010). Mental health outcome measures. London: RC Psych Publications.Google Scholar
Turkington, D and Siddle, R (1998). Cognitive therapy for the treatment of delusions. Advances in Psychiatric Treatment, 4, 235–241.CrossRefGoogle Scholar
van der Krieke, L, Bird, V, Leamy, M, Bacon, F, Dunnm, R, Pesolam, F, … Slade, M (2015). The feasibility of implementing recovery, psychosocial and pharmacological interventions for psychosis: Comparison study. Implementation Science, 10, 73.CrossRefGoogle ScholarPubMed
Westfall, JM, Mol, J and Fagnan, L (2007). Practice-based research—‘blue highways’ on the NIH roadmap. JAMA, 297, 403–406.CrossRefGoogle Scholar
Woolf, SH (2008). The meaning of translational research and why it matters. JAMA, 299, 211–213.CrossRefGoogle ScholarPubMed
Wykes, T, Steel, C, Everitt, B and Tarrier, N (2008). Cognitive behavior therapy for schizophrenia: Effect sizes, clinical models, and methodological rigor. Schizophrenia Bulletin, 34, 523–537.CrossRefGoogle ScholarPubMed