THE NOTTINGHAM STUDY OF NEUROTIC DISORDER - INFLUENCE OF COGNITIVE THERAPISTS ON OUTCOME

Background. In previously published papers from the Nottingham Study o f Neurotic Disorder a short treatment package of cognitive-behaviour t herapy was no more effective than placebo drug treatment after 10 week s' assessment in a cohort of 210 patients with neurotic disorders. Thi s paper examines the outcome over two years of the patients treated by cognitive-behaviour therapy separated into two therapist groups. thos e who were competent in administering treatment and those of uncertain competence. Method. The therapists (mainly community psychiatric nurs es) of 70 patients with an original DSM-III diagnosis of either dysthy mic, panic or generalised anxiety disorder were separated into two gro ups on the basis of their perceived competence by their supervisor (DK ). Ratings of psychopathology were made at regular intervals over two years by assessors blind to knowledge of treatment or therapist. Resul ts. The patients treated by competent therapists (n=30) generally show ed greater improvement than those allocated to therapists of uncertain competence (n=40), mainly with respect to depressive symptoms, and th e difference persisted over two years. long after the cognitive-behavi our therapy had been completed. Conclusions. Cognitive-behaviour thera py given by competent therapists over a 10 week period is of lasting b enefit in neurotic disorder.