LONDON EAST-ANGLIA RANDOMIZED CONTROLLED TRIAL OF COGNITIVE-BEHAVIORAL THERAPY FOR PSYCHOSIS .1. EFFECTS OF THE TREATMENT PHASE

Background A series of small, mainly uncontrolled, studies have sugges ted that techniques adapted from cognitive-behavioural therapy (CBT) f or depression can improve outcome in psychosis, but no large randomise d controlled trial of intensive treatment for medication-resistant sym ptoms of psychosis has previously been published. Method Sixty partici pants who each had at least one positive and distressing symptom of ps ychosis that was medication-resistant were randomly allocated between a CBT and standard care condition (n = 28) and a standard care only co ntrol condition (n = 32). Therapy was individualised, and lasted for n ine months. Multiple assessments of outcome were used. Results Over ni ne months, improvement was significant only in the treatment group, wh o showed a 25% reduction on the BPRS. No other clinical, symptomatic o r functioning measure changed significantly. Participants had a low dr op-out rate from therapy (11%), and expressed high levers of satisfact ion with treatment (80%). Fifty per cent of the CBT group were treatme nt responders (one person became worse), compared with 31% of the cont rol group (three people became worse and another committed suicide). C onclusions CBT for psychosis can improve overall symptomatology The fi ndings provide evidence that even a refractory group of clients with a long history of psychosis can engage in talking about psychotic sympt oms and their meaning, and this can improve outcome.