Hostname: page-component-78c5997874-mlc7c Total loading time: 0 Render date: 2024-11-10T11:16:00.410Z Has data issue: false hasContentIssue false
  • English
  • Français

Group CBT for psychosis in acute care: a review of outcome studies

Published online by Cambridge University Press:  24 February 2015

Mary Owen ,
Tom Speight ,
May Sarsam  and
William Sellwood
Mary Owen*
Affiliation:
Department of Clinical Psychology, University of Liverpool, School of Health and Wellbeing, Institute of Psychology, Health and Society, Whelan Building, Brownlow Hill, Liverpool, UK
Tom Speight
Affiliation:
Broadoak Unit, Mersey Care NHS Trust, Liverpool, Merseyside, UK
May Sarsam
Affiliation:
Broadoak Unit, Mersey Care NHS Trust, Liverpool, Merseyside, UK
William Sellwood
Affiliation:
Clinical Psychology, Division of Health Research, Furness Building, Lancaster University, Lancaster, UK
*
*Author for correspondence: Dr M. Owen, Department of Clinical Psychology, University of Liverpool, School of Health and Wellbeing, Institute of Psychology, Health and Society, Whelan Building, Brownlow Hill, Liverpool, L69 3GB, UK. (email: maryowen1@nhs.net).
Get access Rights & Permissions [Opens in a new window]

Abstract

There is evidence that group cognitive behavioural therapy for psychosis (CBTp) is an effective treatment, but much of this research has been conducted with outpatient populations. The aim of this review was to determine the utility of group CBTp for inpatients. We systematically searched Scopus, Web of Science and EBSCO electronic databases to identify relevant research. We reviewed the resulting articles and included those which had been conducted with inpatients, with symptoms of psychosis, using cognitive behaviour therapy, delivered in a group format. Fourteen articles relating to ten studies were identified. Two were randomized controlled trials; two were cohort studies and the rest were pre-/post-intervention studies. There was considerable heterogeneity between the studies and all had methodological limitations. The findings suggest positive trends towards the reduction of distress associated with psychotic symptoms, increased knowledge of symptoms, decreased affective symptoms and reduced readmissions over several years. However, there is currently not enough evidence to draw any strong conclusions regarding the utility of group CBTp for inpatients due to the small number of studies and limitations in quality and generalizability. Therefore, this review indicates the need for further research, particularly large, methodologically rigorous, randomized controlled trials.

Keywords

CBTgroup psychotherapyinpatient CBTpsychosis
Type
Review
Information
the Cognitive Behaviour Therapist , Volume 8 , 2015 , e2
Copyright
Copyright © British Association for Behavioural and Cognitive Psychotherapies 2015 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Recommended follow-up reading

Clarke, I, Wilson, H (2009). Cognitive Behaviour Therapy for Acute Inpatient Mental Health Units: Working with Clients, Staff and the Mileu. London: Routledge, Taylor & Francis Group.Google Scholar
Cooke, A (2014). Understanding Psychosis and Schizophrenia: Why people sometimes hear voices, believe things that others find strange, or appear out of touch with reality, and what can help. Leicester: British Psychological Society.Google Scholar

References

Aho-Mustonen, K, Miettinen, R, Koivisto, H, Timonen, T, Raty, H (2008). Group psychoeducation for forensic and dangerous non-forensic long-term patients with schizophrenia. A pilot study. European Journal of Psychiatry 22, 84–92.Google Scholar
Aho-Mustonen, K, Tilonen, J, Repo-Tiihonen, E, Ryynanen, OP, Miettinen, R, Raty, H (2011). Group psychoeducation for long-term offender patients with schizophrenia: an exploratory randomised controlled trial. Criminal Behaviour and Mental Health 21, 163–176.Google Scholar
APA (2004). Practice guideline for the treatment of patients with schizophrenia. American Journal of Psychiatry 161, S1–S56.Google Scholar
APA (2009). Proficiency in psychology: the assessment and treatment of serious mental illness. American Psychological Association (http://isps-us.org/blog/wp-content/uploads/2011/08/smi-proficiency.pdf). Accessed 13 June 2013.Google Scholar
Ascher-Svanum, H, Krause, A (1991). Psychoeducational Groups for Patients with Schizophrenia. Gaithersburg, MD: Aspen Publishers.Google Scholar
Atkins, D, Briss, PA, Eccles, M, Flottorp, S, Guyatt, GH, Harbour, RT, Hill, S, Jaeschke, R, Liberati, A, Magrini, N, Mason, J, O’Connell, D, Oxman, AD, Phillips, B, Schünemann, H, Edejer, T, Vist, GE, Williams, JW, The GRADE Working Group. (2005). Systems for grading the quality of evidence and the strength of recommendations II: pilot study of a new system. BMC Health Service Research 5, 1–12.Google Scholar
Bechdolf, A, Knost, B, Kuntermann, C, Schiller, S, Klosterkotter, J, Hambrecht, M, Pukrop, R (2004). A randomised comparison of group cognitive-behavioural therapy and group psychoeducation in patients with schizophrenia. Acta Psychiatrica Scandinavica 110, 21–28.Google Scholar
Bechdolf, A, Knost, B, Nelson, B, Schneider, N, Veith, V, Yung, AR, Pukrop, R (2010). Randomized comparison of group cognitive-behaviour therapy and group psychoeducation in acute patients with schizophrenia: effects on subjective quality of life. Royal Australian and New Zealand College of Psychiatrists 44, 144–150.Google Scholar
Bechdolf, A, Kohn, D, Knost, B, Pukrop, R, Klosterkotter, J (2005). A randomized comparison of group cognitive-behavioural therapy and group psychoeducation in acute patients with schizophrenia: outcome at 24 months. Acta Psychiatrica Scandinavica 112, 173–179.Google Scholar
Bickerdike, A, Matias, L (2010). Thinking about thinking: developing a meta-cognitive approach to group-based cognitive-behavioural therapy for psychosis in a medium secure setting. Clinical Psychology Forum 214, 31–35.Google Scholar
Bright (2006). Star Wards: Practical Ideas for Improving the Daily Experiences and Treatment Outcomes of Acute Metal Health Inpatients. London: Bright.Google Scholar
Canadian Psychiatric Association (2005). Clinical practice guidelines: the treatment of schizophrenia. Canadian Journal of Psychiatry 50, S1.Google Scholar
Centre for Mental Health (2010). The economic and social costs of mental health problems in 2009/10. (http://www.centreformentalhealth.org.uk/pdfs/Economic_and_social_costs_2010.pdf). Accessed 13 January 2013.Google Scholar
Chadwick, P, Sambrooke, S, Rasch, S, Davies, E (2000). Challenging the omnipotence of voices: group cognitive-behaviour therapy for voices. Behaviour Research and Therapy 38, 993–1003.Google Scholar
Chakraborty, K, Basu, D (2010). Insight in schizophrenia – a comprehensive update. German Journal of Psychiatry 13, 17–30.Google Scholar
Department of Health (2007). New ways of working for everyone: a best practice implementation guide. London: Department of Health.Google Scholar
Department of Health & HM Government (2011). No health without mental health: a cross government mental health strategy for people of all ages. London: Crown Copyright.Google Scholar
European Commission (2005). Green Paper. Improving the mental health of the population: Towards a strategy on mental health for the European Union. Brussels: Health & Consumer Protection, Directorate-General.Google Scholar
Fagin, L (2010). Is it possible to make acute wards into therapeutic communities? In: Psychological Groupwork with Acute Psychiatric Inpatients (ed. Radcliffe, J., Hajek, K., Carson, J. and Manor, O.), pp. 21–36. London: Whiting & Birch Ltd.Google Scholar
Free, ML (1999). Cognitive Therapy in Groups: Guidelines and Resources for Practice. New York: Wiley.Google Scholar
Freemantle, B, Clarke, I (2009). Making sense of psychosis in crisis. In: Cognitive Behaviour Therapy for Acute Inpatient Mental Health Units: Working with Clients, Staff and the Mileu (ed. Clarke, I. and Wilson, H.), pp. 84–92. London: Routledge, Taylor & Francis Group.Google Scholar
Gaebel, W, Weinmann, S, Sartorius, N, Rutz, W, McIntyre, JS (2005). Schizophrenia practice guidelines: international survey and comparison. British Journal of Psychiatry 187, 248–255.Google Scholar
Guaiana, G, Morelli, AC, Chiodo, D (2012). Cognitive-behaviour therapy (group) for schizophrenia. Cochrane Database of Systematic Reviews 2. doi:10.1002/14651858.CD009608.Google Scholar
Gugiu, CP, Gugiu, RM (2010). A critical appraisal of standard guidelines for grading levels of evidence. Evaluation & the Health Professions 33, 233–255.Google Scholar
Hagen, R, Nordahl, HM, Grawe, RW (2005). Cognitive-behavioural group treatment of depression in patients with psychotic disorders. Clinical Psychology and Psychotherapy 12, 465–474.Google Scholar
Hanna, J (2009). CBT on the wards: standards and aspirations. In: Cognitive Behaviour Therapy for Acute Inpatient Mental Health Units: Working with Clients, Staff and the Mileu (ed. Clarke, I. and Wilson, H.), pp. 11–21. London: Routledge, Taylor & Francis Group.Google Scholar
Harrington, M, Lelliot, P, Paton, C, Konsolaki, M, Sensky, T, Okocha, T (2002). Variation between services in polypharmacy and combined high dose of antipsychotic drugs prescribed for inpatients. Psychiatric Bulletin 26, 418–420.Google Scholar
Haywood, TW, Kravitz, HM, Grossman, LS, Cavanaugh, JL, Davis, JM, Lewis, DA (1995). Predicting the ‘Revolving Door’ phenomenon among patients with schizophrenia, schizoaffective and affective disorders. American Journal of Psychiatry 152, 856–861.Google Scholar
Jauhar, S, McKenna, PJ, Radua, J, Fung, E, Salvador, R, Laws, KR (2014). Cognitive-behavioural therapy for the symptoms of schizophrenia: systematic review and meta-analysis with examination of potential bias. British Journal of Psychiatry 204, 20–29.Google Scholar
Jones, C, Hacker, D, Cormac, I, Meaden, A, Irving, CB (2012). Cognitive-behaviour therapy versus other psychosocial treatments for schizophrenia. Cochrane Database of Systematic Reviews 4. doi:10.1002/14651858.CD008712.pub2.Google Scholar
Knapp, M, Chisholm, D, Leese, M, Amaddeo, F, Tansella, M, Schene, A, Thornicroft, G, Vazquez-Barquero, JL, Knudsen, HC, Becker, T, the EPSILON Study Group. (2002). Comparing patterns and costs of schizophrenia care in five European countries: the EPSILON study. Acta Psychiatrica Scandinavica 105, 42–54.Google Scholar
Kosters, M, Burlinghame, GM, Nachtigall, C, Strauss, B (2006). A meta-analytic review of the effectiveness of inpatient group psychotherapy. Group Dynamics: Theory, Research and Practice 10, 146–163.Google Scholar
McInnis, E, Sellwood, W, Jones, C (2006). A cognitive-behavioural group-based educational programme for psychotic symptoms in a low secure setting: a pilot evaluation. British Journal of Forensic Practice 8, 36–46.CrossRefGoogle Scholar
Moher, D, Liberati, A, Tetzlaff, J, Altman, DG, the PRISMA Group (2009). Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. PLoS Medicine 6 (7), e1000097.Google Scholar
Morrison, N (2001). Group cognitive therapy: treatment of choice of suboptimal option? Behavioural and Cognitive Psychotherapy 29, 311–332.CrossRefGoogle Scholar
Mortan, O, Tekinsav Sutcu, S, German Kose, G (2011). A pilot study on the effectiveness of a group-based cognitive-behavioral therapy program for coping with auditory hallucinations. Turkish Journal of Psychiatry 22, 1–8.Google Scholar
Mueser, KT, McGurk, SR (2004). Schizophrenia. Lancet 362, 2063–2072.Google Scholar
National Institute for Health and Care Excellence (NICE) (2014). Psychosis and schizophrenia in adults: treatment and management. NICE guideline 178 (http://www.nice.org.uk/guidance/CG178). Accessed 9 September 2014.Google Scholar
National Institute for Health and Clinical Excellence (NICE) (2009). Schizophrenia: Core Interventions in the Treatment and Management of Schizophrenia in Primary and Secondary Care (Updated Edition). Leicester & London: The British Psychological Society & the Royal College of Psychiatrists.Google Scholar
National Institute of Mental Health (2008). Strategic Action Plan. NIH Publication No. 08–6368. U.S. Department of Health and Human Services: National Institutes of Health.Google Scholar
Newton, E, Larkin, M, Melhuish, R, Wykes, T (2007). More than just a place to talk: young people's experiences of group psychological therapy as an early intervention for auditory hallucinations. Psychology and Psychotherapy: Theory, Research and Practice 80, 127–149.Google Scholar
Pinkham, AE, Gloege, AT, Flanagan, S, Penn, DL (2004). Group cognitive-behavioral therapy for auditory hallucinations: a pilot study. Cognitive and Behavioral Practice 11, 93–98.Google Scholar
Raune, D, Daddi, I (2011). Pilot study of group cognitive-behaviour therapy for heterogeneous acute psychiatric inpatients: treatment in a sole-standalone session allowing patients to choose the therapeutic target. Behavioural and Cognitive Psychotherapy 39, 359–365.Google Scholar
Royal Australian and New Zealand College of Psychiatrists (RANZCP) (2005). Clinical practice guidelines for the treatment of schizophrenia and related disorders. Australian and New Zealand Journal of Psychiatry 39, 1–30.Google Scholar
Saksa, JR, Cohen, SJ, Srihari, VH, Woods, SW (2009). Cognitive-behavior therapy for early psychosis: A comprehensive review of individual vs group treatment studies. International Journal of Group Psychotherapy 59, 357–383.Google Scholar
Sarin, F, Wallin, L, Widerlöv, B (2011). Cognitive-behavior therapy for schizophrenia: a meta-analytical review of randomized controlled trials. Nordic Journal of Psychiatry 65, 162–174.Google Scholar
Tani, H, Uchida, H, Suzuki, T, Fujii, Y, Mimura, M (2013). Interventions to reduce antipsychotic polypharmacy: a systematic review. Schizophrenia Research 143, 215–220.Google Scholar
Tarrier, N, Harwood, S, Yusupoff, L, Beckett, R, Baker, A (1990). Coping strategy enhancement (CSE): a method of treating residual schizophrenic symptoms. Behavioural Psychotherapy 18, 283–293.CrossRefGoogle Scholar
Thompson, A, Shaw, M, Harrison, G, Ho, D, Gunnell, D, Verne, J (2004). Patterns of hospital admission for adult psychiatric illness in England: analysis of Hospital Episode Statistics data. British Journal of Psychiatry 185, 334–341.Google Scholar
Turkington, D, Dudley, R, Warman, DM, Beck, AT (2004). Cognitive-behavioural therapy for schizophrenia: a review. Journal of Psychiatric Practice 10, 5–16.Google Scholar
van Os, J, Kapur, S (2009). Schizophrenia. Lancet 374, 635–645.Google Scholar
Velthorst, E, Koeter, M, van der Gaag, M, Nieman, DH, Fett, AK, Smit, F, Staring, ABP, Meijer, C, de Haan, L (2014). Adapted cognitive-behavioural therapy required for targeting negative symptoms in schizophrenia: meta-analysis and meta-regression. Psychological Medicine 22, 1–13.Google Scholar
Veltro, F, Falloon, I, Vendittelli, N, Oricchio, I, Scinto, A, Gigantesco, A, Morosini, P (2006). Effectiveness of cognitive-behavioural group therapy for inpatients. Clinical Practice and Epidemiology in Mental Health 2, 16–21.Google Scholar
Veltro, F, Vendittelli, N, Oricchio, I, Addona, F, Avino, C, Figliolia, G, Morosini, P (2008). Effectiveness and efficiency of cognitive-behavioural therapy for inpatients: a 4-year follow-up study. Journal of Psychiatric Practice 14, 281–288.Google Scholar
WHO (2013). Sixty sixth World Health Assembly: comprehensive mental health action plan 2013–2020 (http://apps.who.int/gb/ebwha/pdf_files/WHA66/A66_R8-en.pdf). World Health Organisation. Accessed 13 June 2013.Google Scholar
Wykes, T (2004). Psychological treatment for voices in psychosis. Cognitive Neuropsychiatry 9, 25–41.Google Scholar
Wykes, T, Parr, A, Landau, S (1999). Group treatment of auditory hallucinations: Exploratory study of effectiveness. British Journal of Psychiatry 175, 180–185.Google Scholar
Wykes, T, Steel, C, Everitt, B, Tarrier, N (2008). Cognitive-behaviour therapy for schizophrenia: effect sizes, clinical models and methodological rigor. Schizophrenia Bulletin 34, 523–537.Google Scholar
Zimmerman, G, Favrod, J, Trieu, V, Pomini, V (2005). The effect of cognitive-behavioral treatment on the positive symptoms of schizophrenia spectrum disorders: a meta-analysis. Schizophrenia Research 77, 1–9.Google Scholar
Submit a response

Comments

No Comments have been published for this article.