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Cognitive behaviour therapy for psychosis can be adapted for minority ethnic groups: a randomised controlled trial

Cognitive behaviour therapy for psychosis can be adapted for minority ethnic groups: a randomised controlled trial
Cognitive behaviour therapy for psychosis can be adapted for minority ethnic groups: a randomised controlled trial
Cognitive behavioural therapy (CBT) is recommended in treatment guidelines for psychotic symptoms (NICE, 2009) but clients from some minority groups have been shown to have higher dropout rates and poorer outcomes. A recent qualitative study in ethnic minority groups concluded that CBT would be acceptable and may be more effective if it was culturally adapted to meet their needs (Rathod et al., 2010).

Aim: This study assessed the effectiveness of a culturally adapted CBT for psychosis (CaCBTp) in Black British,
African Caribbean/Black African and South Asian Muslim participants.

Method: A randomised controlled trial was conducted in two
centres in the UK (n=35) in participants with a diagnosis of a disorder from the schizophrenia group. Assessments were conducted at three time points: baseline, post-therapy and at 6 months follow-up, using the Comprehensive Psychopathological Rating Scale (CPRS) and Insight Scale. Outcomes on specific subscales of CPRS were also evaluated. Participants in the treatment arm completed the Patient Experience Questionnaire (PEQ) to measure satisfaction with
therapy. Assessors blind to randomisation and treatment allocation conducted administration of outcome measures. In total, n=33 participants were randomly allocated to CaCBTp arm (n=16) and treatment as usual (TAU) arm (n=17) after (n=2) participants were excluded. CaCBTp participants were offered 16 sessions of CaCBTp with trained therapists and the TAU arm continued with their standard treatment.

Results: Analysis was based on the principles of intention to treat (ITT). This was further supplemented with secondary sensitivity analyses. Post-treatment, the intervention group showed statistically significant reductions in symptomatology on overall CPRS scores, CaCBTp Mean (SD)=16.23 (10.77), TAU=18.60 (14.84); p=0.047, with a difference in change of 11.31 (95% CI:0. 14 to 22.49); Schizophrenia change: CaCBTp=3.46 (3.37); TAU= 4.78 (5.33) diff 4.62 (95% CI: 0.68 to 9.17); p=0.047 and positive symptoms (delusions; p=0.035, and hallucinations; p=0.056). At 6 months follow-up, MADRAS change=5.6 (95% CI: 2.92 to 7.60); pb0.001. Adjustment was made for age, gender and antipsychotic medication. Overall satisfactionwas significantly correlated with the number of sessions attended (r=0.563; p=0.003).

Conclusion: Participants in the CaCBTp group achieved statistically significant results post-treatment compared to those in the TAU group with some gains maintained at follow-up. High levels of satisfaction with the CaCBTp were reported.
0920-9964
319-326
Rathod, Shanaya
b4dddbe5-e4aa-4069-bd03-20cd6332639c
Phiri, Peter
bdcad679-98c5-47c5-a7ad-15865f1e880e
Harris, Scott
19ea097b-df15-4f0f-be19-8ac42c190028
Underwood, Charlotte
eab0b5e0-6648-45ed-9ad5-67b7bc778195
Thagadur, Mahesh
247ca949-833b-46ce-af96-ec4502843335
Padmanabi, Uma
f9ed38e8-d924-4ac1-bce3-eeb185e8ac82
Kingdon, David
14cdc422-10b4-4b2d-88ec-24fde5f4329b
Rathod, Shanaya
b4dddbe5-e4aa-4069-bd03-20cd6332639c
Phiri, Peter
bdcad679-98c5-47c5-a7ad-15865f1e880e
Harris, Scott
19ea097b-df15-4f0f-be19-8ac42c190028
Underwood, Charlotte
eab0b5e0-6648-45ed-9ad5-67b7bc778195
Thagadur, Mahesh
247ca949-833b-46ce-af96-ec4502843335
Padmanabi, Uma
f9ed38e8-d924-4ac1-bce3-eeb185e8ac82
Kingdon, David
14cdc422-10b4-4b2d-88ec-24fde5f4329b

Rathod, Shanaya, Phiri, Peter, Harris, Scott, Underwood, Charlotte, Thagadur, Mahesh, Padmanabi, Uma and Kingdon, David (2012) Cognitive behaviour therapy for psychosis can be adapted for minority ethnic groups: a randomised controlled trial. Schizophrenia Research, 143 (2-3), 319-326. (doi:10.1016/j.schres.2012.11.007). (PMID:23231878)

Record type: Article

Abstract

Cognitive behavioural therapy (CBT) is recommended in treatment guidelines for psychotic symptoms (NICE, 2009) but clients from some minority groups have been shown to have higher dropout rates and poorer outcomes. A recent qualitative study in ethnic minority groups concluded that CBT would be acceptable and may be more effective if it was culturally adapted to meet their needs (Rathod et al., 2010).

Aim: This study assessed the effectiveness of a culturally adapted CBT for psychosis (CaCBTp) in Black British,
African Caribbean/Black African and South Asian Muslim participants.

Method: A randomised controlled trial was conducted in two
centres in the UK (n=35) in participants with a diagnosis of a disorder from the schizophrenia group. Assessments were conducted at three time points: baseline, post-therapy and at 6 months follow-up, using the Comprehensive Psychopathological Rating Scale (CPRS) and Insight Scale. Outcomes on specific subscales of CPRS were also evaluated. Participants in the treatment arm completed the Patient Experience Questionnaire (PEQ) to measure satisfaction with
therapy. Assessors blind to randomisation and treatment allocation conducted administration of outcome measures. In total, n=33 participants were randomly allocated to CaCBTp arm (n=16) and treatment as usual (TAU) arm (n=17) after (n=2) participants were excluded. CaCBTp participants were offered 16 sessions of CaCBTp with trained therapists and the TAU arm continued with their standard treatment.

Results: Analysis was based on the principles of intention to treat (ITT). This was further supplemented with secondary sensitivity analyses. Post-treatment, the intervention group showed statistically significant reductions in symptomatology on overall CPRS scores, CaCBTp Mean (SD)=16.23 (10.77), TAU=18.60 (14.84); p=0.047, with a difference in change of 11.31 (95% CI:0. 14 to 22.49); Schizophrenia change: CaCBTp=3.46 (3.37); TAU= 4.78 (5.33) diff 4.62 (95% CI: 0.68 to 9.17); p=0.047 and positive symptoms (delusions; p=0.035, and hallucinations; p=0.056). At 6 months follow-up, MADRAS change=5.6 (95% CI: 2.92 to 7.60); pb0.001. Adjustment was made for age, gender and antipsychotic medication. Overall satisfactionwas significantly correlated with the number of sessions attended (r=0.563; p=0.003).

Conclusion: Participants in the CaCBTp group achieved statistically significant results post-treatment compared to those in the TAU group with some gains maintained at follow-up. High levels of satisfaction with the CaCBTp were reported.

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e-pub ahead of print date: 8 December 2012
Organisations: Faculty of Medicine

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Local EPrints ID: 345950
URI: http://eprints.soton.ac.uk/id/eprint/345950
ISSN: 0920-9964
PURE UUID: e8b4caad-fde0-4793-92aa-2c4b0a1b9d18

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Date deposited: 11 Jan 2013 12:07
Last modified: 02 Dec 2019 20:54

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Contributors

Author: Shanaya Rathod
Author: Peter Phiri
Author: Scott Harris
Author: Charlotte Underwood
Author: Mahesh Thagadur
Author: Uma Padmanabi
Author: David Kingdon

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