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Cognitive Behavioral Therapy for Psychosis (CBT-p) Delivered in a Community Mental Health Setting: A Case Comparison of Clients Receiving CBT Informed Strategies by Case Managers Prior to Therapy

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Abstract

This exploratory case comparison examines the influence of case management activities on engagement and progress in psychotherapy for clients with schizophrenia. Six clients were recruited to participate in ten sessions of Cognitive Behavioral Therapy for psychosis (CBT-p). Three clients who had received Cognitive Behavioral techniques for psychosis (CBt-p, a low-intensity case management intervention) prior to receiving therapy were selected from referrals. A comparison group of three clients who had received standard case management services was selected from referrals. Cases within and across groups were compared on outcome measures and observations from case review were offered to inform future research. Delivering CBT-p services on a continuum from low- to high-intensity is discussed.

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References

  • Asberg, M., Montgomery, S. A., Perris, C., Schalling, D., & Sedvall, G. (1978). A comprehensive psychopathological rating scale. Acta Psychiatrica Scandinavica, 57(S271), 5–27.

    Article  Google Scholar 

  • Bennett-Levy, J., Richards, D. A., Ferrand, P., Christensen, H., Griffiths, K. M., Kavanagh, D. J., & Williams, C. (Eds.). (2010). Oxford guide to low intensity CBT interventions. New York; NY: Oxford University Press.

    Google Scholar 

  • Chakraborty, K., & Basu, D. (2010). Insight in schizophrenia—A comprehensive update. The German Journal of Psychiatry, 13, 17–30.

    Google Scholar 

  • David, A. S. (1990). Insight and psychosis. British Journal of Psychiatry, 156, 798–808.

    Article  CAS  PubMed  Google Scholar 

  • Dekeyser, M., Prouty, G., & Elliott, R. (2008). Pre-therapy process and outcome: A review of research instruments and findings. Person-Centered and Experiential Psychotherapies, 7(1), 37–55.

    Article  Google Scholar 

  • Farhall, J., Freeman, N. C., Shawyer, F., & Trauer, T. (2009). An effectiveness trial of cognitive behaviour therapy in a representative sample of outpatients with psychosis. British Journal of Clinical Psychology, 48(1), 47–62.

    Article  PubMed  Google Scholar 

  • Goldsmith, L. P., Lewis, S. W., Dunn, G., Bentall, R. P. (2015). Psychological treatments for early psychosis can be beneficial or harmful, depending on the therapeutic alliance: an instrumental variable analysis. Psychological Medicine, Mar 25:1-9.

  • Haddock, G., McCarron, J., Tarrier, N., & Faragher, E. B. (1999). Scales to measure dimensions of hallucinations and delusions: The psychotic symptoms rating scales (PSYRATS). Psychological Medicine, 29(4), 879–889.

    Article  CAS  PubMed  Google Scholar 

  • Horvath, A. O., & Greenberg, L. S. (1989). Development and validation of the working alliance inventory. Journal of Counseling Psychology, 36(2), 223–233.

    Article  Google Scholar 

  • Jauhar, S., McKenna, P. J., Radua, J., Fung, E., Salvador, R., & Laws, K. R. (2014). Cognitive-behavioural therapy for the symptoms of schizophrenia: Systematic review and meta-analysis with examination of potential bias. British Journal of Psychiatry, 204(1), 20–29.

    Article  CAS  PubMed  Google Scholar 

  • Kawata, A. K., & Revicki, D. A. (2008). Psychometric properties of the Personal and Social Performance scale (PSP) among individuals with schizophrenia living in the community. Quality of Life Research, 17(2), 1247–1256.

    Article  PubMed  Google Scholar 

  • Krakvik, B., Grawe, R. W., Hagen, R., & Stiles, T. C. (2013). Cognitive behaviour therapy for psychotic symptoms: A randomized controlled effectiveness trial. Behavioural and Cognitive Psychotherapy, 41(5), 511–524.

    Article  PubMed  PubMed Central  Google Scholar 

  • Kreyenbuhl, J., Buchanan, R. W., Dickerson, F. B., & Dixson, L. B. (2010). The schizophrenia patient outcomes research team (PORT): Updated treatment recommendations 2009. Schizophrenia Bulletin, 36(1), 94–103.

    Article  PubMed  Google Scholar 

  • Lincoln, T. M., Ziegler, M., Mehl, S., Kesting, M. L., Lullmann, E., Westermann, S., & Rief, W. (2012). Moving from efficacy to effectiveness in cognitive behavioral therapy for psychosis: A randomized clinical practice trial. Journal of Consulting and Clinical Psychology, 80(4), 674–686.

    Article  PubMed  Google Scholar 

  • Lindström, E., & Lindström, L. H. (1996). A subscale for negative symptoms from the Comprehensive Psychopathological Rating Scale (CPRS): A comparison with the schedule for assessment of negative symptoms (SANS). European Archives of Psychiatry and Clinical Neuroscience, 246(4), 219–223.

    Article  PubMed  Google Scholar 

  • Lynch, D., Laws, K. R., & McKenna, P. J. (2010). Cognitive behavioural therapy for major psychiatric disorder: Does it really work? A meta-analytical review of well-controlled trials. Psychological Medicine, 40(1), 9–24.

    Article  CAS  PubMed  Google Scholar 

  • Morosini, P. L., Magliano, L., Brambilla, L., Ugolini, S., & Pioli, R. (2000). Development, reliability and acceptability of a new version of the DSM-IV Social and Occupational Functioning Assessment Scale (SOFAS) to assess routine social functioning. Acta Psychiatrica Scandinavica, 101(4), 323–329.

    CAS  PubMed  Google Scholar 

  • Morrison, A. P., Renton, J. C., Williams, S., Dunn, H., Knight, A., Kreutz, M., & Dunn, G. (2004). Delivering cognitive therapy to people with psychosis in a community mental health setting: An effectiveness study. Acta Psychiatrica Scandinavica, 110(1), 36–44.

    Article  CAS  PubMed  Google Scholar 

  • Nasrallah, H., Morosini, P., & Gagnon, D. D. (2008). Reliability, validity and ability to detect change of the Personal and Social Performance scale in patients with stable schizophrenia. Psychiatry Research, 161(2), 213–224.

    Article  PubMed  Google Scholar 

  • National Institute for Health and Care Excellence (NICE) Guidelines CG178. (2014). Psychosis and schizophrenia in adults: Treatment and management (update). National Institute for Clinical Excellence: London. Retrieved from https://www.nice.org.uk/guidance/cg178.

  • Neil, S. T., Kilbride, M., Pitt, L., Nothard, S., Welford, M., Sellwood, W., & Morrison, A. (2009). The questionnaire about the process of recovery (QPR): A measurement tool developed in collaboration with service users. Psychosis, 1(2), 145–155.

    Article  Google Scholar 

  • Peters, E., Landau, S., McCrone, P., Cooke, M., Fisher, P., Steel, C., & Kuipers, E. (2010). A randomised controlled trial of cognitive behaviour therapy for psychosis in a routine clinical service. Acta Psychiatrica Scandinavica, 122(4), 302–318.

    Article  PubMed  Google Scholar 

  • Pinninti, N. R., Fisher, J., Thompson, K., & Steer, R. (2010). Feasibility and usefulness of training assertive community treatment team in cognitive behavioral therapy. Community Mental Health Journal, 46(4), 337–341.

    Article  PubMed  Google Scholar 

  • Pinninti, N. R., Schmidt, L. T., & Snyder, R. P. (2014). Case manager as therapy extender for cognitive behavior therapy of serious mental illness: A case report. Community Mental Health Journal, 50(4), 422–426.

    Article  PubMed  Google Scholar 

  • Prouty, G. F. (1990). Pre-therapy: A theoretical evolution in the person-centered/experiential psychotherapy of schizophrenia and retardation. In G. Lietaer, J. Rombauts, & R. Van Balen (Eds.), Client-centered and experiential psychotherapy in the nineties (pp. 645–658). Leuven, Belgium: Leuven University Press.

    Google Scholar 

  • Tracey, T. J., & Kokotovic, A. M. (1989). Factor structure of the working alliance inventory. Psychological Assessment: A Journal of Consulting and Clinical Psychology, 1, 207–210.

    Article  Google Scholar 

  • Turkington, D., Kingdon, D., & Turner, T. (2002). Effectiveness of a brief cognitive-behavioural therapy intervention in the treatment of schizophrenia. British Journal of Psychiatry, 180, 523–527.

    Article  PubMed  Google Scholar 

  • Turkington, D., Munetz, M., Pelton, J., Montesano, V., Sivec, H., Nausheen, B., & Kingdon, D. (2014). High-yield cognitive behavioral techniques for psychosis delivered by case managers to their clients with persistent psychotic symptoms: An exploratory trial. Journal of Nervous and Mental Disease, 202(1), 30–34.

    Article  PubMed  Google Scholar 

  • Turner, D. T., van der Gaag, M., Karyotaki, E., & Cuijpers, P. (2014). Psychological interventions for psychosis: A meta-analysis of comparative outcome studies. American Journal of Psychiatry, 171(5), 523–538.

    Article  PubMed  Google Scholar 

  • Waller, H., Garety, P. A., Jolley, S., Fornells-Ambrojo, M., Kuipers, E., Onwumere, J., & Craig, T. (2013). Low intensity cognitive behavioural therapy for psychosis: A pilot study. Journal of Behavior Therapy and Experimental Psychiatry, 44(1), 98–104.

    Article  CAS  PubMed  Google Scholar 

  • 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.

    Article  PubMed  Google Scholar 

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Acknowledgments

The authors are grateful to The Margaret Clark Morgan Foundation for their initial generous grant to establish the Best Practices in Schizophrenia Treatment (BeST) Center at Northeast Ohio Medical University (NEOMED) and to Community Support Services for their support of BeST Center projects.

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Correspondence to Harry J. Sivec.

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Sivec, H.J., Montesano, V.L., Skubby, D. et al. Cognitive Behavioral Therapy for Psychosis (CBT-p) Delivered in a Community Mental Health Setting: A Case Comparison of Clients Receiving CBT Informed Strategies by Case Managers Prior to Therapy. Community Ment Health J 53, 134–142 (2017). https://doi.org/10.1007/s10597-015-9930-0

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