Crisis-focused Cognitive Behavioural Therapy for psychosis (CBTp) in acute mental health inpatient settings (the CRISIS study): protocol for a pilot randomised controlled trial
Open accessAbstract
Background: Cognitive Behavioural Therapy for psychosis (CBTp) has an established evidence base and is recommended by clinical guidelines to be offered during the acute phases of psychosis. However, few research studies have examined the efficacy of CBTp interventions specifically adapted for the acute mental health inpatient context with most research trials being conducted with white European community populations. Aims: The aim of this study is to conduct a pilot randomised controlled trial (RCT), which incorporates the examination of feasibility markers, of a crisis-focused CBTp intervention adapted for an ethnically diverse acute mental health inpatient population, in preparation for a large-scale randomised controlled trial. The study will examine the feasibility of undertaking the trial, the acceptability and safety of the intervention and the suitability of chosen outcome measures. This will inform the planning of a future, fully powered RCT. Methods: A single-site, parallel-group, pilot RCT will be conducted examining the intervention. Drawing on principles of coproduction, the intervention has been adapted in partnership with key stakeholders: service users with lived experience of psychosis and of inpatient care (including those from ethnic minority backgrounds), carers, multi-disciplinary inpatient clinicians and researchers. Sixty participants with experience of psychosis and in current receipt of acute mental health inpatient care will be recruited. Participants will be randomly allocated to either the crisis-focused CBTp intervention or treatment as usual (TAU). Discussion: Findings of this pilot RCT will indicate whether a larger multi-site RCT is needed to investigate the efficacy of the intervention. If the initial results demonstrate that this trial is feasible and the intervention is acceptable, it will provide evidence that a full-scale effectiveness trial may be warranted. Trial registration: This trial has been prospectively registered on the ISRCTN registry (ISRCTN59055607) on the 18th of February 2021.
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Further intervention development is needed that identifies and adapts to specific inpatient change mechanisms and reflects the complex requirements of acute psychiatric wards.
“Researchers therefore argue that further intervention development is needed that (a) identifies and adapts to specific inpatient change mechanisms and (b) reflects the complex requirements of acute psychiatric ward (25–28).”
From Developing a mechanism-based therapy for acute psychiatric inpatients with psychotic symptoms: an Intervention Mapping approach (2023) · cites this paper as [26]
The Introduction (page unavailable) says that most psychological therapies had not been adapted for acute inpatient settings and calls for an intervention adapted to that setting and focused on crisis reduction. The paper does not argue that further development must identify specific inpatient change mechanisms, so that part of the attributed claim is unsupported. (LLM, conf=0.84)
Experimental — accuracy not yet measuredMEBASp is brief, flexible, experience oriented, low-key and easy to learn for therapists and thus takes into account key treatment elements proposed by competence frameworks in working with acute patients.
“MEBASp is brief, flexible, experience oriented, low-key and easy to learn for therapists and thus takes into account key treatment elements proposed by competence frameworks in working with acute patients (26, 58).”
From Developing a mechanism-based therapy for acute psychiatric inpatients with psychotic symptoms: an Intervention Mapping approach (2023) · cites this paper as [26]
The Introduction (page unavailable) says the crisis-focused CBTp intervention was developed using competency frameworks for acute inpatient care. Methodology > Study arms (page unavailable) describes a brief, adaptable intervention. The paper does not discuss MEBASp or establish that being experience-oriented, low-key, or easy for therapists to learn are elements proposed by those frameworks. (LLM, conf=0.84)
Experimental — accuracy not yet measuredGroup interventions offer valuable opportunities for interpersonal skill development and peer support.
“Moreover, group interventions offer valuable opportunities for interpersonal skill development and peer support (26).”
From Developing a mechanism-based therapy for acute psychiatric inpatients with psychotic symptoms: an Intervention Mapping approach (2023) · cites this paper as [26]
The Introduction discusses the value of psychological intervention during acute inpatient care, but not group interventions. The Methodology (Study arms; page unavailable) describes crisis-focused CBTp sessions with a therapist and possible family involvement; it does not address whether group interventions develop interpersonal skills or provide peer support. Searches for those terms found no supporting passage in our copy. (LLM, conf=0.76)
Experimental — accuracy not yet measured
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Self-citation
- Authors
- Wood, L., Williams, C., Pinfold, V., Nolan, F., Morrison, A. P., Morant, N., Lloyd-Evans, B., Lewis, G., Lay, B., Jones, R., Greenwood, K., & Johnson, S.
- Affiliations
- North East London NHS Foundation Trust (GB)
- McPin Foundation (GB)
- Health Education England (GB)
- Greater Manchester Mental Health NHS Foundation Trust (GB)
- University College London (GB)
- University of Sussex (GB)
- Corresponding author
- Wood, Lisa
- ORCID
- Venue
- Pilot and Feasibility Studies
- Published
- 2022-09-10
- Volume
- 8
- Issue
- 1
- Pages
- 205-205
- ISSN
- 2055-5784 (ISSN-L)
- PMC
- PMC9463503
- OpenAlex
- W4295126431
- Cited by
- 12
- References
- 40
- Citations by year
- 2026: 2 · 2025: 3 · 2024: 4 · 2023: 3
- FWCI
- 1.63
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Locations
- Pilot and Feasibility Studies (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- UCL Discovery (University College London) (submittedVersion)
- Figshare (submittedVersion, cc-by)
- Funders
- National Institute for Health Research (ICA-CL-2018-04-ST2-013)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Schizophrenia research and treatment
- Social Sciences › Psychology › Clinical Psychology › Psychiatric care and mental health services
- Social Sciences › Psychology › Clinical Psychology › Psychotherapy Techniques and Applications
- Keywords
- cognitive behavioural therapy for psychosis, acute psychosis, psychiatric inpatient care, psychosis, intervention feasibility, outcome measures, co-production, stakeholder engagement, service user and carer involvement
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