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Measuring adherence in social recovery therapy with people with first episode psychosis

  • Christine Lowen (a1), Jo Hodgekins (a2), Katherine Pugh (a3), Clio Berry (a3) (a4), Mike Fitzsimmons (a5), Paul French (a6) (a7), Catarina Sacadura (a3), Max Birchwood (a8), Chris Jackson (a9), Eleanor Baggott (a10), Mark Bernard (a9) and David Fowler (a4)...

Abstract

Background:

The SUPEREDEN3 study, a phase II randomized controlled trial, suggests that social recovery therapy (SRT) is useful in improving functional outcomes in people with first episode psychosis. SRT incorporates cognitive behavioural therapy (CBT) techniques with case management and employment support, and therefore has a different emphasis to traditional CBT for psychosis, requiring a new adherence tool.

Aims:

This paper describes the SRT adherence checklist and content of the therapy delivered in the SUPEREDEN3 trial, outlining the frequency of SRT techniques and proportion of participants who received a full therapy dose. It was hypothesized that behavioural techniques would be used frequently, consistent with the behavioural emphasis of SRT.

Method:

Research therapists completed an adherence checklist after each therapy session, endorsing elements of SRT present. Data from 1236 therapy sessions were reviewed to determine whether participants received full, partial or no therapy dose.

Results:

Of the 75 participants randomized to receive SRT, 57.3% received a full dose, 24% a partial dose, and 18.7% received no dose. Behavioural techniques were endorsed in 50.5% of sessions, with cognitive techniques endorsed in 34.9% of sessions.

Conclusions:

This report describes an adherence checklist which should be used when delivering SRT in both research and clinical practice. As hypothesized, behavioural techniques were a prominent feature of the SRT delivered in SUPEREDEN3, consistent with the behavioural emphasis of the approach. The use of this adherence tool would be considered essential for anyone delivering SRT looking to ensure adherence to the model.

Copyright

Corresponding author

*Corresponding author. Email: j.hodgekins@uea.ac.uk

References

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Bighelli, I., Salanti, G., Huhn, M., Schneider-Thoma, J., Krause, M., Reitmeir, C., Wallis, S., Schwermann, F., Pitschel-Walz, G., Barbui, C., Furukawa, T. A., & Leucht, S. (2018). Psychological interventions to reduce positive symptoms in schizophrenia: systematic review and network meta-analysis. World Psychiatry, 17, 316329.
Blackburn, I., James, I. A., Milne, D. L., Baker, C., Standart, S., Garland, A., & Reichelt, K. (2001). The revised cognitive therapy scale (CTS-R): psychometric properties. Behavioural and Cognitive Psychotherapy, 29, 431446.
Dunn, G., Fowler, D., Rollinson, R., Freeman, D., Kuipers, E., Smith, B., Steel, C., Onwunere, J., Jolley, S., Garety, P., & Bebbington, P. (2012). The effective elements of cognitive behaviour therapy for psychosis: results of a novel type of subgroup analysis based on principal stratification. Psychological Medicine, 42, 10571068.
Flach, C., French, P., Dunn, G., Fowler, D., Gumley, A. I., Birchwood, M., Stewart, S. L. K., & Morrison, A. P. (2015). Components of therapy as mechanisms of change in cognitive therapy for people at risk of psychosis: analysis of the EDIE-2 trial. British Journal of Psychiatry, 207, 123129.
Fowler, D., French, P., Hodgekins, J., Lower, R., Turner, R., Burton, S., & Wilson, J. (2013). CBT to address and prevent social disability in early and emerging psychosis. In Steel, C. (ed), CBT for Schizophrenia: Evidence-Based Interventions and Future Directions. Oxford, UK: John Wiley & Sons Ltd.
Fowler, D., French, P., Banerjee, R., Barton, G., Berry, C., Byrne, R., Clarke, T., Fraser, R., Gee, B., Greenwood, K., Notley, C., Parker, S., Shepstone, L., Wilson, J., Yung, A. R., & Hodgekins, J. (2017a). Prevention and treatment of long-term social disability amongst young people with emerging severe mental illness with social recovery therapy (The PRODIGY Trial): study protocol for a randomised controlled trial. Trials, 18, 315.
Fowler, D., Hodgekins, J., & French, P. (2017b). Social recovery therapy in improving activity and social outcomes in early psychosis: current evidence and longer term outcomes. Schizophrenia Research, https://doi.org/10.1016/j_schres.2017.10.006
Fowler, D., Hodgekins, J., French, P., Marshall, M., Freemantle, N., McCrone, P., Everard, L., Lavis, A., Jones, P. B., Amos, T., Singh, S., Sharma, V., & Birchwood, M. (2018). Social recovery therapy in combination with early intervention services for enhancement of social recovery in patients with first-episode psychosis (SUPEREDEN3): a single-blind, randomised controlled trial. Lancet Psychiatry, 5, 4150.
Fowler, D., Hodgekins, J., Painter, M., Reilly, T., Crane, C., Macmillan, I., Mugford, M., Croudace, T., & Jones, P. B. (2009). Cognitive behaviour therapy for improving social recovery in psychosis: a report from the ISREP MRC Trial Platform study (Improving Social Recovery in Early Psychosis). Psychological Medicine, 39, 16271636.
Fowler, D., Rollinson, R., & French, P. (2011). Adherence and competence assessment in studies of CBT for psychosis: current status and future directions. Epidemiology and Psychiatric Sciences, 20, 121126.
Garety, P. A., Fowler, D. G., Freeman, D., Bebbington, P., Dunn, G., & Kuipers, E. (2008). Cognitive-behavioural therapy and family intervention for relapse prevention and symptom reduction in psychosis: randomised controlled trial. British Journal of Psychiatry, 192, 412423.
Hodgekins, J., Birchwood, M., Christopher, R., Marshall, M., Coker, S., Everard, L. … & Fowler, D. (2015). Investigating trajectories of social recovery in individuals with first-episode psychosis: a latent class growth analysis. British Journal of Psychiatry, 207, 536543.
Hodgekins, J., & Fowler, D. (2010). CBT and recovery from psychosis in the ISREP trial: mediating effects of hope and positive beliefs on activity. Psychiatric Services, 61, 321324.
James, I. A., Blackburn, I. M., & Reichelt, F. K. (2001). Manual of the Revised Cognitive Therapy Scale (CTS-R). Available at: https://www.getselfhelp.co.uk/docs/CTSRmanual.pdf
Rollinson, R., Smith, B., Steel, C., Jolley, S., Onwumere, J., Garety, P. A., Kuipers, E., … & Fowler, D. (2008). Measuring adherence in CBT for psychosis: a psychometric analysis of an adherence scale. Behavioural and Cognitive Psychotherapy, 36, 163178.
Spencer, H. M., McMenamin, M., Emsley, R., Turkington, D., Dunn, G., Morrison, A. P., Brabban, A., Hutton, P., & Dudley, R. (2018). Cognitive behavioral therapy for antipsychotic-free schizophrenia spectrum disorders: does therapy dose influence outcome? Schizophrenia Research, https://doi.org/10.1016/j.schres.2018.07.016
Startup, M., Jackson, M., & Pearce, E. (2002). Assessing therapist adherence to cognitive-behaviour therapy for psychosis. Behavioural and Cognitive Psychotherapy, 30, 329339.
Waltz, J., Addis, M. E., Koerner, K., & Jacobson, N. S. (1993). Testing the integrity of a psychotherapy protocol: assessment of adherence and competence. Journal of Consulting and Clinical Psychology, 61, 620630.
Wykes, T. (2014). Cognitive-behaviour therapy and schizophrenia. Evidence Based Mental Health, 17, 6768.
Wykes, T., Steel, C., Everitt, B., & Tarrier, N. (2007). Cognitive behaviour therapy for schizophrenia: effect sizes, clinical models and methodological rigor. Schizophrenia Bulletin, 34, 523537.
Young, J., & Beck, A. T. (1980). Cognitive Therapy Scale Rating Manual. Available at: www.academyofct.org

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Measuring adherence in social recovery therapy with people with first episode psychosis

  • Christine Lowen (a1), Jo Hodgekins (a2), Katherine Pugh (a3), Clio Berry (a3) (a4), Mike Fitzsimmons (a5), Paul French (a6) (a7), Catarina Sacadura (a3), Max Birchwood (a8), Chris Jackson (a9), Eleanor Baggott (a10), Mark Bernard (a9) and David Fowler (a4)...
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