Incorporating psychotherapeutic methods in routine community treatment for patients with psychotic disorders

Abstract

PURPOSE: This study sought to establish which psychotherapeutic methods can be used effectively in routine clinical encounters (in contrast to formal therapy) with people with psychotic disorders. METHODS: To identify psychotherapeutic methods for use in routine community care, a range of experts were consulted. A literature search was then undertaken to establish the evidence base for the identified techniques in this setting. RESULTS: Five methods were identified as suitable for this application. More literature was identified for adapting solution-focused therapy, client-centred therapy and cognitive behavioural therapy (CBT) for routine psychiatric care than for adapting problem solving therapy and interpersonal therapy. Also more studies have investigated the use of CBT in psychosis than the other methods. However there is a dearth of evidence addressing this application of the methods. At this stage, there is no compelling evidence base to consider any of the five methods superior to the others for use in this setting. CONCLUSIONS: More empirical research addressing the effectiveness and optimising the models of psychotherapeutic methods for routine community treatment of people with psychotic disorders is required. Such research might guide training of clinicians and influence practice of community care.

Keywords:

• psychotic disorders
• psychotherapeutic techniques
• outpatient effectiveness

Acknowledgements

We are grateful to Moira Kelly, Sir David Goldberg, Wulf Roessler, David Kingdon, Swaran Singh, Patrick Corrigan, Tom Burns, Lars Hansson and Len Bowers who supported the study as experts for selecting relevant methods.