Cognitively oriented psychotherapy for early psychosis (COPE): A 1-year follow-up

Objectives. Cognitively oriented psychotherapy for early psychosis (COPE) i s aimed at facilitating the adjustment of the person, and at preventing or alleviating secondary morbidity in the wake of the first psychotic episode. Design. A total of 80 people participated in the initial trial and complete d assessments on a range of outcome measures. Post-treatment assessment res ults from a non-randomized controlled trial of COPE have been previously re ported. The present paper describes the results obtained from 51 patients w ho attended a follow-up assessment 1 year subsequent to the end-of-treatmen t assessment. Method. The 51 patients formed three groups: (1) those who were offered and accepted COPE; (2) chose who were offered COPE but refused it, and continu ed to receive other services from the Early Psychosis Prevention and Interv ention Centre (EPPIC) (refusal subjects): and (3) chose who were offered ne ither COPE nor any other continuing treatment from EPPIC (control subjects) . Results. At 1-year follow-up, there was only one significant difference and this was between che COPE and refusal groups on the Integration/Sealing Ov er (1:SO) measure (p = .008). End-of-treatment differences were mostly sust ained over the 1-year follow-up period. When the complete sample of 80 was considered, there were no differences between the three groups in terms of hospital admissions, community episodes, or time taken to first in-patient re-admission. Conclusions. The study was weakened by the poor follow-up rates in che two control groups. This reduced power to detect differences between groups on the seven major measures. However, the relapse data gathered on the complet e set of 80 patients were discouraging and suggest that the present formula tion of COPE does not confer any advantage to chose patients receiving the therapy over those not receiving the therapy.