Group cognitive-behavioural therapy for
                        schizophrenia

Barrowclough, Christine; Haddock, Gillian; Lobban, Fiona; Jones, Steven H.; Siddle, Ron; Roberts, Chris; Gregg, Lynsey

doi:10.1192/bjp.bp.106.021386

Cited by 107 publications

(48 citation statements)

References 20 publications

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“…89,95,[103][104][105] These conclusions are largely consistent with the results of recent meta-analyses. [106][107][108] However, some studies have not found CBT to improve patient outcomes in these domains including hallucinations, 105 positive symptoms, [109][110][111][112] negative symptoms, [109][110][111][112] and social functioning. 98,109,110 The effects of CBT on depression, suicidality, hopelessness, illness insight, relapse, and rehospitalization have not been clearly established with only a small number of studies examining these outcomes.…”

Section: Supported Employmentmentioning

confidence: 99%

The 2009 Schizophrenia PORT Psychosocial Treatment Recommendations and Summary Statements

Dixon

Dickerson

Bellack

et al. 2009

Schizophrenia Bulletin

690

534

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Section: Supported Employmentmentioning

confidence: 99%

The 2009 Schizophrenia PORT Psychosocial Treatment Recommendations and Summary Statements

Dixon

Dickerson

Bellack

et al. 2009

Schizophrenia Bulletin

690

534

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“…A number of influential research studies have demonstrated that patients with schizophrenia who are treated with CBT often experience a reduction in delusions, hallucinations, and negative symptoms that go beyond the results of pharmacotherapy alone. 24,25,35 CBT is partly based on the evidence that emotional processes, information processing deficits, reasoning, and appraisal biases contribute to the formation and maintenance of delusions and hallucinations, and partly on changing these processes through cognitive intervention. CBT has significant effects on brain functioning and other biological processes.…”

Section: Discussionmentioning

confidence: 99%

“…47 Also, other authors have demonstrated that CBT contributed to significantly greater improvements in terms of verbal learning, psychomotor speed, and global cognitive functioning. 24,25,[48][49][50][51][52][53][54][55][56][57][58] Many of the studies that were reviewed have demonstrated the effectiveness of the CRT intervention. For example, Lindenmayer et al evaluated the feasibility and efficacy of a CRT program for improving cognitive and work functioning for intermediate-to longstay psychiatric inpatients.…”

Section: Monthsmentioning

confidence: 99%

“…[20][21][22] In fact, many studies have demonstrated that various types of cognitive training (CT) may improve neuropsychological performance, psychosocial functioning, and psychiatric symptoms severity. [23][24][25] The aim of the present paper was to evaluate the efficacy of nonpharmacological treatments in patients affected by schizophrenia including cognitive behavioral therapy (CBT), social skills therapy (SST), family intervention therapy (FIT), cognitive remediation therapy (CRT), and other nonpharmacological therapeutic strategies.…”

Section: Introductionmentioning

confidence: 99%

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Support management in schizophrenia: a systematic review of current literature

Pompili¹,

Montebovi²,

Forte³

et al. 2012

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Background: Schizophrenia is generally considered a chronic disorder characterized by psychotic symptoms and relatively stable neurocognitive and interpersonal deficits. Antipsychotic medication has proven beneficial in reducing psychotic symptoms, but is often not enough to treat cognitive or functional impairments. Residual cognitive impairments are barriers to a patient's full recovery from schizophrenia. Rehabilitation is an alternative and important approach which may be useful, and encompasses a variety of treatments including social skills training and psychoeducational and cognitive behavioral treatments. Objective: To investigate the efficacy of psychosocial treatments in schizophrenia, evaluating its effects in the short and long term, comparing psychosocial treatments with pharmacotherapy, and assessing the effects of treatment and the main indications for use in patients with schizophrenia. Methods: A careful MEDLINE ® , Excerpta Medica, PsycLIT ® , PsycINFO ® , and IndexMedicus search was performed to identify all papers and book chapters in English for the period 1970-2012. Results:Findings from the studies included in this qualitative analysis suggest that social skills therapy, cognitive behavioral therapy, family intervention therapy, cognitive remediation therapy, and other nonpharmacological therapeutic strategies may be beneficial for patients with significant functional and symptomatic impairments. Conclusion: Schizophrenic patients treated with nonpharmacological techniques have more rapid remission and relapse less frequently than patients treated only pharmacologically.

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“…35 Thus, part of the recovery process involves the challenges of remaining optimistic and fulfilling full potential and well-being. While there is clearly a strong evidence base for CBTP, including much of our own work, [36][37][38][39][40][41] research indicates that CBTP does not significantly reduce suicide behaviour; 42 thus, the development of CBT for suicide prevention is a priority. There are also other limitations with respect to the delivery of CBTP mentioned above, so alternative modes of delivery need to be explored.…”

Section: Introductionmentioning

confidence: 98%

Psychological approaches to understanding and promoting recovery in psychosis and bipolar disorder: a mixed-methods approach

Morrison

Law

Barrowclough

et al. 2016

Programme Grants Appl Res

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BackgroundRecovery in mental health is a relatively new concept, but it is becoming more accepted that people can recover from psychosis. Recovery-orientated services are recommended for adult mental health, but with little evidence base to support this.ObjectivesTo facilitate understanding and promotion of recovery in psychosis and bipolar disorder (BD), in a manner that is empowering and acceptable to service users.MethodThere were six linked projects using qualitative and quantitative methodologies: (1) developing and piloting a service user-defined measure of recovery; (2) a Delphi study to determine levels of consensus around the concept of recovery; (3) examination of the psychological factors associated with recovery and how these fluctuate over time; (4) development and evaluation of cognitive–behavioural approaches to guided self-help including a patient preference trial (PPT); (5) development and evaluation of cognitive–behavioural therapy (CBT) for understanding and preventing suicide in psychosis including a randomised controlled trial (RCT); and (6) development and evaluation of a cognitive–behavioural approach to recovery in recent onset BD, including a RCT of recovery-focused cognitive–behavioural therapy (RfCBT). Service user involvement was central to the programme.ResultsMeasurement of service user-defined recovery from psychosis (using the Subjective Experience of Psychosis Scale) and BD (using the Bipolar Recovery Questionnaire) was shown to be feasible and valid. The consensus study revealed a high level of agreement among service users for defining recovery, factors that help or hinder recovery and items which demonstrate recovery. Negative emotions, self-esteem and hope predicted recovery judgements, both cross-sectionally and longitudinally, whereas positive symptoms had an indirect effect. In the PPT, 89 participants entered the study, three were randomised, 57 were retained in the trial until 15-month follow-up (64%). At follow-up there was no overall treatment effect on the primary outcome (Questionnaire about the Process of Recovery total;p = 0.82). In the suicide prevention RCT, 49 were randomised and 35 were retained at 6-month follow-up (71%). There were significant improvements in suicidal ideation [Adult Suicidal Ideation Questionnaire; treatment effect = –12.3, 95% confidence interval (CI) –24.3 to –0.14], Suicide Probability Scale (SPS; treatment effect = –7.0, 95% CI –15.5 to 0) and hopelessness (subscale of the SPS; treatment effect = –3.8, 95% CI –7.3 to –0.5) at follow-up. In the RCT for BD, 67 participants were randomised and 45 were retained at the 12-month follow-up (67%). Recovery score significantly improved in comparison with treatment as usual (TAU) at follow-up (310.87, 95% CI 75.00 to 546.74). At 15-month follow-up, 32 participants had experienced a relapse of either depression or mania (20 TAU vs. 12 RfCBT). The difference in time to recurrence was significant (estimated hazard ratio 0.38, 95% CI 0.18 to 0.78;p < 0.006).ConclusionsThis research programme has improved our understanding of recovery in psychosis and BD. Key findings indicate that measurement of recovery is feasible and valid. It would be feasible to scale up the RCTs to assess effectiveness of our therapeutic approaches in larger full trials, and two of the studies (CBT for suicide prevention in psychosis and recovery in BD) found significant benefits on their primary outcomes despite limited statistical power, suggesting definitive trials are warranted.FundingThe National Institute for Health Research Programme Grants for Applied Research programme.

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Group cognitive-behavioural therapy for schizophrenia

Abstract: Although group cognitive-behavioural therapy may not be the optimum treatment method for reducing hallucinations and delusions, it may have important benefits, including feeling less negative about oneself and less hopeless for the future.

Cited by 107 publications

References 20 publications

The 2009 Schizophrenia PORT Psychosocial Treatment Recommendations and Summary Statements

The 2009 Schizophrenia PORT Psychosocial Treatment Recommendations and Summary Statements

Support management in schizophrenia: a systematic review of current literature

Psychological approaches to understanding and promoting recovery in psychosis and bipolar disorder: a mixed-methods approach

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