The University of Southampton
University of Southampton Institutional Repository

High-yield cognitive behavioral techniques for psychosis delivered by case managers to their clients with persistent psychotic symptoms an exploratory trial

High-yield cognitive behavioral techniques for psychosis delivered by case managers to their clients with persistent psychotic symptoms an exploratory trial
High-yield cognitive behavioral techniques for psychosis delivered by case managers to their clients with persistent psychotic symptoms an exploratory trial
Case managers spend more time with clients with schizophrenia than any other professional group does in most clinical settings in the United States. Cognitive behavioral therapy (CBT) adapted for individuals with persistent psychotic symptoms, referred to as CBT-p, has proven to be a useful intervention when given by expert therapists in randomized clinical trials. It is currently unknown whether techniques derived from CBT-p could be safely and effectively delivered by case managers in community mental health agencies. Thirteen case managers at a community mental health center took part in a 5-day training course and had weekly supervision. In an open trial, 38 clients with schizophrenia had 12 meetings with their case managers during which high-yield cognitive behavioral techniques for psychosis (HYCBt-p) were used. The primary outcome measure was overall symptom burden as measured by the Comprehensive Psychopathological Rating Scale, which was independently administered at baseline and end of intervention. Secondary outcomes were dimensions of hallucinations and delusions, negative symptoms, depression, anxiety, social functioning, and self-rated recovery. Good and poor clinical outcomes were defined a priori as a 25% improvement or deterioration. t-Tests and Wilcoxon’s signed-ranks tests showed significant improvements in all primary and secondary outcomes by the end of the intervention except for delusions, social functioning, and self-rated recovery. Cohen’s d effect sizes were medium to large for overall symptoms (d = 1.60; 95% confidence interval [CI], ?2.29 to 5.07), depression (d = 1.12; 95% CI, ?0.35 to 1.73), and negative symptoms (d = 0.87; 95% CI, ?0.02 to 1.62). There was a weak effect on dimensions of hallucinations but not delusions. Twenty-three (60.5%) of 38 patients had a good clinical result. One (2.6%) of 38 patients had a poor clinical result. No patients dropped out. This exploratory trial provides evidence supportive of the safety and the benefits of case managers being trained to provide HYCBt-p to their clients with persistent psychosis. The benefits reported here are particularly pertinent to the domains of overall symptom burden, depression, and negative symptoms and implementation of recovery-focused services.
case managers, hycbt-p, cbt-p, recovery, schizophrenia, psychosis
0022-3018
30-34
Turkington, D.
a1e362f5-4ff3-4d27-81cb-1c6ddbcbf5b9
Munetz, M.
24fbef50-c59e-468a-b2f2-fb81a49383cf
Pelton, J.
2e9938e0-662c-440d-bd52-b03e07de7388
Montesano, V.
db06475c-32e9-44f4-84f9-e105d927fdad
Sivec, H.
9a30b523-ff1a-4aa4-b0cf-ba2b7bdf917f
Nausheen, B.
8e24bce4-df6d-4009-bd77-144dec5178bd
Kingdon, David
14cdc422-10b4-4b2d-88ec-24fde5f4329b
Turkington, D.
a1e362f5-4ff3-4d27-81cb-1c6ddbcbf5b9
Munetz, M.
24fbef50-c59e-468a-b2f2-fb81a49383cf
Pelton, J.
2e9938e0-662c-440d-bd52-b03e07de7388
Montesano, V.
db06475c-32e9-44f4-84f9-e105d927fdad
Sivec, H.
9a30b523-ff1a-4aa4-b0cf-ba2b7bdf917f
Nausheen, B.
8e24bce4-df6d-4009-bd77-144dec5178bd
Kingdon, David
14cdc422-10b4-4b2d-88ec-24fde5f4329b

Turkington, D., Munetz, M., Pelton, J., Montesano, V., Sivec, H., Nausheen, B. and Kingdon, David (2014) High-yield cognitive behavioral techniques for psychosis delivered by case managers to their clients with persistent psychotic symptoms an exploratory trial. Journal of Nervous and Mental Disease, 202 (1), 30-34. (doi:10.1097/NMD.0000000000000070). (PMID:24375209)

Record type: Article

Abstract

Case managers spend more time with clients with schizophrenia than any other professional group does in most clinical settings in the United States. Cognitive behavioral therapy (CBT) adapted for individuals with persistent psychotic symptoms, referred to as CBT-p, has proven to be a useful intervention when given by expert therapists in randomized clinical trials. It is currently unknown whether techniques derived from CBT-p could be safely and effectively delivered by case managers in community mental health agencies. Thirteen case managers at a community mental health center took part in a 5-day training course and had weekly supervision. In an open trial, 38 clients with schizophrenia had 12 meetings with their case managers during which high-yield cognitive behavioral techniques for psychosis (HYCBt-p) were used. The primary outcome measure was overall symptom burden as measured by the Comprehensive Psychopathological Rating Scale, which was independently administered at baseline and end of intervention. Secondary outcomes were dimensions of hallucinations and delusions, negative symptoms, depression, anxiety, social functioning, and self-rated recovery. Good and poor clinical outcomes were defined a priori as a 25% improvement or deterioration. t-Tests and Wilcoxon’s signed-ranks tests showed significant improvements in all primary and secondary outcomes by the end of the intervention except for delusions, social functioning, and self-rated recovery. Cohen’s d effect sizes were medium to large for overall symptoms (d = 1.60; 95% confidence interval [CI], ?2.29 to 5.07), depression (d = 1.12; 95% CI, ?0.35 to 1.73), and negative symptoms (d = 0.87; 95% CI, ?0.02 to 1.62). There was a weak effect on dimensions of hallucinations but not delusions. Twenty-three (60.5%) of 38 patients had a good clinical result. One (2.6%) of 38 patients had a poor clinical result. No patients dropped out. This exploratory trial provides evidence supportive of the safety and the benefits of case managers being trained to provide HYCBt-p to their clients with persistent psychosis. The benefits reported here are particularly pertinent to the domains of overall symptom burden, depression, and negative symptoms and implementation of recovery-focused services.

Full text not available from this repository.

More information

Published date: January 2014
Keywords: case managers, hycbt-p, cbt-p, recovery, schizophrenia, psychosis
Organisations: Faculty of Medicine

Identifiers

Local EPrints ID: 367279
URI: http://eprints.soton.ac.uk/id/eprint/367279
ISSN: 0022-3018
PURE UUID: 09ef44cb-4d15-4dc3-8229-e2dd522a83e9

Catalogue record

Date deposited: 19 Aug 2014 11:50
Last modified: 16 Jul 2019 20:59

Export record

Altmetrics

Contributors

Author: D. Turkington
Author: M. Munetz
Author: J. Pelton
Author: V. Montesano
Author: H. Sivec
Author: B. Nausheen
Author: David Kingdon

University divisions

Download statistics

Downloads from ePrints over the past year. Other digital versions may also be available to download e.g. from the publisher's website.

View more statistics

Atom RSS 1.0 RSS 2.0

Contact ePrints Soton: eprints@soton.ac.uk

ePrints Soton supports OAI 2.0 with a base URL of http://eprints.soton.ac.uk/cgi/oai2

This repository has been built using EPrints software, developed at the University of Southampton, but available to everyone to use.

We use cookies to ensure that we give you the best experience on our website. If you continue without changing your settings, we will assume that you are happy to receive cookies on the University of Southampton website.

×