Abstract
Research has shown that cognitive-behavioral therapy (CBT) is effective in the treatment of schizophrenia (Wykes et al. in Schizophr Bull 34(3):523–537, 2008). The majority of this research has been conducted in the United Kingdom (Beck and Rector in Am J Psychother 54:291–300, 2000) where the National Health Service recommends that CBT be delivered to all people with schizophrenia (NICE in Schizophrenia: core interventions in the treatment and management of schizophrenia in primary and secondary care (update). http://www.nice.org.uk/Guidance/CG82/NiceGuidance/pdf/English, 2009). In contrast, the corresponding American Psychiatric Association guidelines describe CBT as an adjunctive technique that “may benefit” patients (Lehman et al. in Am J Psychiatry 161:1–56, 2004, p. 35). Anecdotal evidence also suggests a difference between UK and US clinicians’ use of and views on CBT with schizophrenia (Tarrier in Clinical handbook of psychological disorders: a step-by-step treatment manual. Guilford, New York, 2008). In the present study 214 clinicians in the UK and US completed an internet survey examining this apparent discrepancy. UK and US participants were equally aware that empirical research supports the efficacy of CBT with schizophrenia. However, UK participants were more likely to practice CBT, rated CBT effectiveness more highly, and were more optimistic about the chances of recovery. These findings suggest fundamental differences in the attitudes and practices of UK and US clinicians.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Barlow, D. H. (2005). What’s new about evidence-based assessment? Psychological Assessment, 17, 308–311.
Beck, A. T. (2005). The current state of cognitive therapy. Archives of General Psychiatry, 62, 953–959.
Beck, A. T., & Rector, N. A. (2000). Cognitive therapy for schizophrenia: A new therapy for the new millennium. American Journal of Psychotherapy, 54, 291–300.
Birchwood, M., Mason, R., MacMillan, F., & Healey, J. (1993). Depression, demoralization and control over psychotic illness: A comparison of depressed and non-depressed patients with chronic psychosis. Psychological Medicine, 23, 387–395.
Chadwick, P., Birchwood, M., & Trower, P. (1996). Cognitive therapy for delusions, voices and paranoia. Oxford: Wiley.
Crits-Christoph, P., Wilson, G., & Hollon, S. (2005). Empirically supported psychotherapies: Comment on Western, Novotny, and Thompson-Brenner (2004). Psychological Bulletin, 131(3), 412–417.
Davidson, L., & McGlashan, T. H. (1997). The varied outcomes of schizophrenia. Canadian Journal of Psychiatry, 42, 34–43.
Dickerson, F. B. (2004). Update on cognitive behavioral psychotherapy for schizophrenia: Review of recent studies. Journal of Cognitive Psychotherapy, 18(3), 189–205.
Fowler, D., Garety, P., & Kuipers, E. (1998). Cognitive therapy for psychosis: Formulation, treatment, effects and service implications. Journal of Mental Health, 7, 123–134.
Gould, R. A., Mueser, K. T., Bolton, E., Mays, V., & Goff, D. (2001). Cognitive therapy for psychosis in schizophrenia: An effect size analysis. Schizophrenia Research, 48, 335–342.
Hogarty, G. E., Kornblith, S. J., Greenwald, D., DiBarry, A. L., Cooley, S., Flesher, S., et al. (1995). Personal therapy: A disorder-relevant psychotherapy for schizophrenia. Schizophrenia Bulletin, 21, 379–393.
Kane, J. M. (1996). Treatment resistant schizophrenic patients. Journal of Clinical Psychiatry, 57(suppl. 9), 35–40.
Kingdon, D., Rathod, S. R., Hansen, L., Naeem, F., & Wright, J. H. (2007). Combining cognitive therapy and pharmacotherapy for schizophrenia. Journal of Cognitive Psychotherapy, 21, 28–36.
Kingdon, D., & Turkington, D. (2005). Cognitive therapy of schizophrenia. New York: Guilford Press.
Lehman, A. F., Lieberman, J. A., Dixon, L. B., McGlashan, T. H., Miller, A. L., Perkins, D. O., et al. (2004). Practice guideline for the treatment of patients with schizophrenia, second edition. American Journal of Psychiatry, 161, 1–56.
Lieberman, J. A., Stroup, T. S., McEvoy, J. P., Swartz, M. S., Rosenheck, R. A., Perkins, D. O., et al. (2005). Effectiveness of antipsychotic drugs in patients with chronic schizophrenia. New England Journal of Medicine, 353, 1209–1223.
Mueser, K. T., & McGurk, S. R. (2004). Schizophrenia. Lancet, 363, 263–272.
National Institute for Clinical Excellence. (2009). Schizophrenia: Core interventions in the treatment and management of schizophrenia in primary and secondary care (update). Retrieved April 20, 2009, from http://www.nice.org.uk/Guidance/CG82/NiceGuidance/pdf/English.
Pilling, S., Bebbington, P., Kuipers, E., Garety, P., Geddes, J., Orbach, G., et al. (2002). Psychological treatments in schizophrenia: I. Meta-analysis of family intervention and cognitive behaviour therapy. Psychological Medicine, 32, 763–782.
Ralph, R., & Corrigan, P. (2005). Recovery in mental illness: Broadening our understanding of wellness. Washington, DC: American Psychological Association.
Rector, N. A., & Beck, A. T. (2001). Cognitive behavior therapy for schizophrenia: An empirical review. Journal of Nervous and Mental Disease, 189, 278–287.
Resnick, S., Fontana, A., Lehman, A., & Rosenheck, R. (2005). An empirical conceptualization of the recovery orientation. Schizophrenia Research, 75(1), 119–128.
Social Care Institute for Excellence. (2008). SCIE position paper 08: A common purpose: Recovery in future mental health services. Retrieved May 5, 2009, from http://www.scie.org.uk/publications/positionpapers/pp08.asp.
Tarrier, N. (2005). Cognitive behaviour therapy for schizophrenia—a review of development, evidence and implementation. Psychotherapy and Psychosomatics, 74, 136–144.
Tarrier, N. (2008). Schizophrenia and other psychotic disorders. In D. H. Barlow (Ed.), Clinical handbook of psychological disorders: A step-by-step treatment manual (4th ed., pp. 463–491). New York, NY: Guilford.
Tarrier, N., & Wykes, T. (2004). Is there evidence that cognitive behavior therapy is an effective treatment for schizophrenia: A cautious or cautionary tale? Behaviour Research and Therapy, 42, 1377–1401.
Turkington, D., Kingdon, D., & Weiden, P. J. (2006). Cognitive behavior for schizophrenia. American Journal of Psychiatry, 163, 365–373.
Turkington, D., & McKenna, P. (2003). Is cognitive-behavioural therapy a worthwhile treatment for psychosis? British Journal of Psychiatry, 182, 477–479.
Turkington, D., Sensky, T., Scott, J., Barnes, T., Nur, U., Siddle, R., et al. (2008). A randomized controlled trial of cognitive-behavior therapy for persistent symptoms in schizophrenia: A five-year follow-up. Schizophrenia Research, 98, 1–7.
White, M., & Epston, D. (1990). Narrative means to therapeutic ends. New York: W.W. Norton & Co.
Wykes, T., Steel, C., Everitt, B., & Tarrier, N. (2008). Cognitive behavior therapy for schizophrenia: Effect sizes, clinical models, and methodological rigor. Schizophrenia Bulletin, 34(3), 523–537.
Zimmermann, G., Favrod, J., Trieu, V. H., & Pomini, V. (2005). The effect of cognitive behavioral treatment on the positive symptoms of schizophrenia spectrum disorders: A meta-analysis. Schizophrenia Research, 77, 1–9.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Kuller, A.M., Ott, B.D., Goisman, R.M. et al. Cognitive Behavioral Therapy and Schizophrenia: A Survey of Clinical Practices and Views on Efficacy in the United States and United Kingdom. Community Ment Health J 46, 2–9 (2010). https://doi.org/10.1007/s10597-009-9223-6
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10597-009-9223-6