Increasing access to psychological therapies for people with psychosis: Predictors of successful training
Open accessAbstract
Background Cognitive behavioural therapy for psychosis (CBTp) is recommended for people with schizophrenia, but routine delivery remains limited. Obstacles to increasing access include inadequate training, organisational support and supervision, resulting in low levels of staff competence and confidence. This study is a preliminary evaluation of a CBTp training programme, designed to overcome these obstacles and to increase routine delivery of competent CBTp.Method Training outcomes for a pilot group and for the first three cohorts to complete training were analysed to identify predictors of successful completion and of therapy delivery after training.Results Objective competence was attained by 37 students (out of 58), who delivered therapy to over 160 service users. Successful completion was associated with previous CBT therapy experience. Delivery after one year was associated with working in a therapy rather than a care co-ordination role.Conclusions The programme succeeded in training therapists to deliver competent therapy. Our results suggest that preliminary training in CBT for other disorders may improve success rates in CBTp. Despite extensive service liaison, delivery remained problematic for care co-ordinators without role change and provision of dedicated time. The findings should inform future implementation strategies.
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Case managers cannot fulfil the role of delivering CBTp.
“Evidence to date suggests that case managers cannot fulfil this role”
From Increasing access to CBT for psychosis patients: A feasibility, randomised controlled trial evaluating brief, targeted CBT for distressing voices delivered by assistant psychologists (GiVE2) (2020) · cites this paper as [19]
The Implications for future implementation section says care co-ordination and formal therapy were hard to combine and that a dedicated therapy role appeared necessary. But the categorical claim goes too far: the Factors impacting on delivery at follow-up section reports that two care co-ordinators practised without difficulty after securing protected CBTp time. (LLM, conf=0.88)
Experimental — accuracy not yet measuredOutcomes from trials of case managers delivering CBTp have been inconclusive.
“outcomes from trials have been inconclusive [16–19]”
From Increasing access to CBT for psychosis patients: A feasibility, randomised controlled trial evaluating brief, targeted CBT for distressing voices delivered by assistant psychologists (GiVE2) (2020) · cites this paper as [19]
The Introduction says efforts to train the mental health workforce to deliver psychosocial interventions for psychosis have had limited success, with very limited effects on patient outcomes. That supports the general concern, but the paper does not characterize outcomes from trials specifically of case managers delivering CBTp as inconclusive; its Implications for future implementation section also notes positive results from some frontline-staff training initiatives. Page numbers are unavailable in our copy. (LLM, conf=0.78)
Experimental — accuracy not yet measuredThere are competing demands upon case managers' time.
“there are competing demands upon their time [18, 19]”
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References 24 · Cited by 36
Research works printed but not linked: 1
- NICE, 2011. Review of Clinical Guideline (CG82) Core interventions in the treatment and management of schizophrenia in adults in primary and secondary care (update of CG1) London: National Institute of Health & Clinical Excellence.
- Authors
- Jolley, S., Onwumere, J., Kuipers, E., Craig, T., Moriarty, A., & Garety, P.
- Affiliations
- University of London (GB)
- Oxleas NHS Foundation Trust (GB)
- Corresponding author
- Jolley, Suzanne
- Venue
- Behaviour Research and Therapy
- Publisher
- Elsevier BV
- Published
- 2012-08
- Volume
- 50
- Issue
- 7-8
- Pages
- 457-462
- ISSN
- 0005-7967 (ISSN-L)
- OpenAlex
- W2042818680
- Cited by
- 36
- References
- 24
- Citations by year
- 2026: 1 · 2025: 1 · 2024: 4 · 2023: 2 · 2021: 1 · 2020: 4 · 2019: 5 · 2018: 2 · 2017: 2 · 2016: 4 · 2015: 2 · 2014: 5 · 2013: 3
- FWCI
- 2.28
- Type
- journal article
- Language
- en
- Open access
- green
- kclpure.kcl.ac.uk
- Licence
- Locations
- Behaviour Research and Therapy (publishedVersion)
- PubMed (publishedVersion)
- Research Portal (King's College London) (publishedVersion, cc-by-nc-nd)
- Funders
- South London & Maudsley Trustees
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Schizophrenia research and treatment
- Health Sciences › Health Professions › General Health Professions › Health Policy Implementation Science
- Social Sciences › Psychology › Clinical Psychology › Psychiatric care and mental health services
- Keywords
- cognitive behavioural therapy for psychosis, schizophrenia, therapist training, access to psychotherapy, training outcomes, therapist competence, role transition
- MeSH terms
- Administrative Personnel, Clinical Competence, Follow-Up Studies, Health Personnel, Health Services Accessibility, Humans, Personal Satisfaction, Pilot Projects, Psychotic Disorders, Students, Medical, Teaching, Program Evaluation, Cognitive Behavioral Therapy, Patient Satisfaction
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