Low intensity cognitive behavioural therapy for psychosis: A pilot study

Background and objectivesThe dissemination and delivery of psychological therapies for people with psychosis has been limited by workforce and organisational factors. ‘Low Intensity’ (LI) delivery, whereby staff are trained to deliver brief, focused, manualised interventions, may be one way of improving access. In this study, we piloted a new LI intervention specifically for people with psychosis, aimed at helping people to reach a personal recovery goal, whilst targeting anxious avoidance or depression-related inactivity. Frontline mental health workers were trained to deliver the intervention. We report here on the impact of the intervention on therapeutic outcomes.MethodsTwelve people with psychosis and either anxious avoidance or low mood, who wanted to work towards a personal goal, completed the intervention and a battery of assessments of mood, functioning and psychotic symptoms.ResultsEleven out of the twelve participants achieved their personal goals. The results of a series of Friedman K related sample tests revealed significant improvements in depression, clinical distress, activity levels, negative symptoms and delusions across the three time points, and no change in hallucinations, or anxious avoidance. Staff and participant satisfaction was high.LimitationsThe study is a small uncontrolled pilot study. Outcomes should therefore be interpreted with caution, pending replication.ConclusionsThe new LI intervention shows preliminary evidence of effectiveness and is a feasible model of therapy delivery for people with psychosis. The results suggest that frontline mental health workers can be trained relatively easily to deliver the intervention. A larger, randomised controlled trial is warranted to determine the effectiveness of the intervention and training programme.

► There is a lack of trained staff to deliver CBT to people with psychosis.
► We evaluated a low intensity CBT therapy focused on achieving personal goals.
► The intervention was delivered by frontline mental health staff after brief training.
► The intervention resulted in achievement of goals and improved mood, activity and delusions.
► A larger, randomised controlled trial of the intervention is warranted.