Increasing access to psychological therapies for people with psychosis: Predictors of successful training

BackgroundCognitive behavioural therapy for psychosis (CBTp) is recommended for people with schizophrenia, but routine delivery remains limited. Obstacles to increasing access include inadequate training, organisational support and supervision, resulting in low levels of staff competence and confidence. This study is a preliminary evaluation of a CBTp training programme, designed to overcome these obstacles and to increase routine delivery of competent CBTp.MethodTraining outcomes for a pilot group and for the first three cohorts to complete training were analysed to identify predictors of successful completion and of therapy delivery after training.ResultsObjective competence was attained by 37 students (out of 58), who delivered therapy to over 160 service users. Successful completion was associated with previous CBT therapy experience. Delivery after one year was associated with working in a therapy rather than a care co-ordination role.ConclusionsThe programme succeeded in training therapists to deliver competent therapy. Our results suggest that preliminary training in CBT for other disorders may improve success rates in CBTp. Despite extensive service liaison, delivery remained problematic for care co-ordinators without role change and provision of dedicated time. The findings should inform future implementation strategies.

► Students attained RCT standard competence in CBTp, across professions.
► Success in training was predicted by previous CBT experience.
►  Successful delivery was predicted by working in a dedicated therapist role, irrespective of profession.
► Workforce development plans should explicitly include role change.
► Alternative implementation strategies could further improve access.