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Cited by 129Schizophrenia research and treatmentPsychotherapy Techniques and ApplicationsMental Health and Psychiatry

Does cognitive behavior therapy for psychosis (CBTp) show a sustainable effect on delusions? A meta-analysis

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Mehl, Stephanie, Werner, Dirk, Lincoln, Tania M.·2015·Frontiers in Psychology
DOI 10.3389/fpsyg.2015.01450PMC PMC4593948
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Abstract

Cognitive Behavior Therapy for psychosis (CBTp) is an effective treatment resulting in small to medium effect sizes with regard to changes in positive symptoms and psychopathology. As a consequence, CBTp is recommended by national guidelines for all patients with schizophrenia. However, although CBTp was originally developed as a means to improve delusions, meta-analyses have generally integrated effects for positive symptoms rather than for delusions. Thus, it is still an open question whether CBTp is more effective with regard to change in delusions compared to treatment as usual (TAU) and to other interventions, and whether this effect remains stable over a follow-up period. Moreover, it would be interesting to explore whether newer studies that focus on specific factors involved in the formation and maintenance of delusions (causal-interventionist approach) are more effective than the first generation of CBTp studies. A systematic search of the trial literature identified 19 RCTs that compared CBTp with TAU and/or other interventions and reported delusions as an outcome measure. Meta-analytic integration resulted in a significant small to medium effect size for CBTp in comparison to TAU at end-of-therapy (k = 13; [Formula: see text] 0.27) and after an average follow-up period of 47 weeks (k = 12; [Formula: see text] 0.25). When compared with other interventions, there was no significant effect of CBTp at end-of-therapy (k = 8; [Formula: see text] 0.16) and after a follow-up period (k = 5; [Formula: see text]). Comparison between newer studies taking a causal-interventionist approach (k = 4) and first-generation studies showed a difference of 0.33 in mean effect sizes in favor of newer studies at end-of-therapy. The findings suggest that CBTp is superior to TAU, but is not superior to other interventions, in bringing about a change in delusions, and that this superiority is maintained over the follow-up period. Moreover, interventions that focus on causal factors of delusions seem to be a promising approach to improving interventions for delusions.

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  • CBTp is a psychological treatment for individuals who, after pharmacological treatment, still live with symptoms of psychosis.

    “Cognitive Behavior Therapy for psychosis (CBTp) is a psychological treatment for individuals who, after pharmacological treat­ ment, still live with symptoms of psychosis (Mehl et al., 2015; Sarin et al., 2011).”

    From Acceptance and Commitment Therapy for inpatients with psychosis –an acceptability and feasibility single case AB designed study (2022) · cites this paper as Mehl et al., 2015

    The Introduction describes CBTp as a psychological intervention for psychosis and an effective adjunct to standard care; the Methods say standard care includes prescribed medication. But the paper does not restrict CBTp to people who still have symptoms after pharmacological treatment: the Introduction says guidelines recommend it in all phases, and the Results include a study of patients who refused antipsychotic medication. No page numbers are available in our copy. (LLM, conf=0.86)

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Research works printed but not linked: 3

  1. Freeman D. Freeman J. (2012). You Can Be Happy: The Scientifical Proven Way to Change How You Feel. Harlow: Prentice Hall Life.
  2. Hedges L. V. Olkin I. (1985). Statistic Methods for Meta-analysis. Orlando, FL: Academic Press.
  3. Jaspers K. (1913). Psychopathologie. Berlin: Springer.

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Authors
Mehl, S., Werner, D., & Lincoln, T. M.
Affiliations
  • Philipps University of Marburg (DE)
  • Universität Hamburg (DE)
Corresponding author
Mehl, Stephanie
ORCID
Venue
Frontiers in Psychology
Publisher
Frontiers Media SA
Published
2015-10-06
Volume
6
Pages
1450-1450
ISSN
1664-1078 (ISSN-L)
DOI
10.3389/fpsyg.2015.01450
PMC
PMC4593948
OpenAlex
W2101083353
Cited by
129
References
73
Citations by year
2026: 7 · 2025: 7 · 2024: 8 · 2023: 11 · 2022: 15 · 2021: 10 · 2020: 11 · 2019: 16 · 2018: 19 · 2017: 10 · 2016: 14 · 2015: 1
FWCI
2.02
Type
journal article
Language
en
Update notices
corrigendum (2019-08-28)
Open access
Licence
Locations
  • Frontiers in Psychology (publishedVersion, cc-by)
  • Europe PMC (PubMed Central) (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
Topics
  • Health Sciences › Medicine › Psychiatry and Mental health › Schizophrenia research and treatment
  • Social Sciences › Psychology › Clinical Psychology › Psychotherapy Techniques and Applications
  • Social Sciences › Arts and Humanities › Philosophy › Mental Health and Psychiatry
Keywords
delusions, schizophrenia, maintenance of treatment effects, treatment as usual comparison, positive symptoms, long-term follow-up, psychotherapy effectiveness

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