Skip to main content Accessibility help
×
Home
Hostname: page-component-544b6db54f-fg2fv Total loading time: 0.404 Render date: 2021-10-23T19:00:45.871Z Has data issue: true Feature Flags: { "shouldUseShareProductTool": true, "shouldUseHypothesis": true, "isUnsiloEnabled": true, "metricsAbstractViews": false, "figures": true, "newCiteModal": false, "newCitedByModal": true, "newEcommerce": true, "newUsageEvents": true }

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

Published online by Cambridge University Press:  05 August 2019

Christine Lowen
Affiliation:
Norfolk and Suffolk Mental Health Foundation Trust, Norwich, UK
Jo Hodgekins*
Affiliation:
Department of Clinical Psychology, Norwich Medical School, University of East Anglia, Norwich, UK
Katherine Pugh
Affiliation:
Sussex Partnership NHS Foundation Trust, Worthing, UK
Clio Berry
Affiliation:
Sussex Partnership NHS Foundation Trust, Worthing, UK University of Sussex, Brighton, UK
Mike Fitzsimmons
Affiliation:
Lancashire Care NHS Foundation Trust, Preston, UK
Paul French
Affiliation:
Psychosis Research Unit, Greater Manchester Mental Health NHS Trust, Manchester, UK Institute of Health and Psychology, University of Liverpool, Liverpool, UK
Catarina Sacadura
Affiliation:
Sussex Partnership NHS Foundation Trust, Worthing, UK
Max Birchwood
Affiliation:
University of Warwick, Warwick, UK
Chris Jackson
Affiliation:
Birmingham Women’s and Children’s NHS Foundation Trust, Birmingham, UK
Eleanor Baggott
Affiliation:
Canterbury District Health Board, Christchurch, New Zealand
Mark Bernard
Affiliation:
Birmingham Women’s and Children’s NHS Foundation Trust, Birmingham, UK
David Fowler
Affiliation:
University of Sussex, Brighton, UK
*
*Corresponding author. Email: j.hodgekins@uea.ac.uk

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.

Type
Main
Copyright
© British Association for Behavioural and Cognitive Psychotherapies 2019 

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

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.CrossRefGoogle ScholarPubMed
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.CrossRefGoogle Scholar
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.CrossRefGoogle ScholarPubMed
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.CrossRefGoogle ScholarPubMed
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.Google Scholar
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.CrossRefGoogle ScholarPubMed
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 CrossRefGoogle Scholar
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.CrossRefGoogle ScholarPubMed
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.CrossRefGoogle Scholar
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.CrossRefGoogle ScholarPubMed
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.CrossRefGoogle ScholarPubMed
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.CrossRefGoogle ScholarPubMed
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.CrossRefGoogle ScholarPubMed
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 Google Scholar
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.CrossRefGoogle Scholar
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 CrossRefGoogle Scholar
Startup, M., Jackson, M., & Pearce, E. (2002). Assessing therapist adherence to cognitive-behaviour therapy for psychosis. Behavioural and Cognitive Psychotherapy, 30, 329339.CrossRefGoogle Scholar
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.CrossRefGoogle ScholarPubMed
Wykes, T. (2014). Cognitive-behaviour therapy and schizophrenia. Evidence Based Mental Health, 17, 6768.CrossRefGoogle Scholar
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.CrossRefGoogle ScholarPubMed
Young, J., & Beck, A. T. (1980). Cognitive Therapy Scale Rating Manual. Available at: www.academyofct.org Google Scholar
Submit a response

Comments

No Comments have been published for this article.
1
Cited by

Send article to Kindle

To send this article to your Kindle, first ensure no-reply@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about sending to your Kindle. Find out more about sending to your Kindle.

Note you can select to send to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be sent to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

Find out more about the Kindle Personal Document Service.

Measuring adherence in social recovery therapy with people with first episode psychosis
Available formats
×

Send article to Dropbox

To send this article to your Dropbox account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Dropbox.

Measuring adherence in social recovery therapy with people with first episode psychosis
Available formats
×

Send article to Google Drive

To send this article to your Google Drive account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Google Drive.

Measuring adherence in social recovery therapy with people with first episode psychosis
Available formats
×
×

Reply to: Submit a response

Please enter your response.

Your details

Please enter a valid email address.

Conflicting interests

Do you have any conflicting interests? *