Implementing psychological treatment for symptoms of psychosis in an area mental health service: The response of patients, therapists and managers

Abstract

The effectiveness and acceptance of a CBT for psychosis intervention that focussed on coping enhancement for voices and delusions, was studied in routine practice in an ordinary mental health service. Twenty-two of 30 referred patients received the intervention. Acceptance by the 22 patients was high, and positive symptom ratings and GAF scores improved following therapy. Eleven of 14 area psychologists availed themselves of training and support opportunities. While uptake of cases was variable, with two therapists accounting for 79% of registered cases, 50% claimed additional limited implementation of CBT principles with non-registered patients. The 14 service managers saw the therapy as effective and considered 36% of service users to be potential candidates for CBT for psychosis. However CBT was not seen as a high service priority and psychologists were generally allocated little additional therapy time. These findings raise issues about the dissemination of innovation into routine practice including management of change and the need to investigate the efficacy of more limited implementation of treatment packages.