Predictors of disengagement from cognitive behavioural therapy for psychosis in a National Health Service setting: a retrospective evaluation
Predictors of disengagement from cognitive behavioural therapy for psychosis in a National Health Service setting: a retrospective evaluation
Objectives: to evaluate whether demographic and clinical variables are related to disengagement rates in cognitive behavioural therapy (CBT) for psychosis in a clinical setting.
Methods: the medical records and symptom severity data (from Health of the Nation Outcome Scales) were analysed retrospectively for 103 referrals for CBT for psychosis in a National Health Service secondary care and Early Intervention in Psychosis team.
Results: overall, 42.7% (n = 44) disengaged from CBT. There was no impact of gender or ethnicity, and no impact of clinical variables such as risk history and comorbid diagnosis. However, risk of disengagement was significantly higher for those who were younger, F = 6.89, partial η2 = .064, p = <.05; those with greater total HoNOS scores, F = 4.22, partial η2 = .04, p < .05; more severe symptoms on the HoNOS items of overactive, aggressive, disruptive, or agitated behaviour, χ2 = 6.13, p < .01; problem drinking or drug taking, χ2 = 7.65, p < .05; depressed mood, χ2 = 7.0, p < .01; and problems with occupation and activities: χ2 = 3.68, p < .05. There was a non‐significant trend for shorter waiting times to be associated with greater levels of disengagement.
Conclusions: these results indicate that it may not be psychosis per se that disrupts engagement in CBT, but linked behavioural and emotional factors. A more assertive approach to these factors – overactive, aggressive, disruptive, or agitated behaviour, problem drinking or drug taking, depressed mood, and problems with occupation and activities, particularly in younger people – may be valuable prior to or early on in therapy as a means of increasing engagement in CBT for psychosis.
440-451
Richardson, Thomas
f8d84122-b061-4322-a594-5ef2eb5cad0d
Dasyam, Ben
26c3c137-17ca-48b0-9dbe-3a41596cc650
Courtney, Helen
1088e9f5-add5-411b-a870-a456d2b8c073
White, Lucy
1858354f-abd6-48fa-a229-6ddccccbdd5a
Tedbury, Jo
7f87b54f-c9eb-437b-9292-444b34e09db4
Butt, Jane
28423c2f-2497-461b-8851-9bd52ea8a028
Newman-Taylor, Katherine
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November 2019
Richardson, Thomas
f8d84122-b061-4322-a594-5ef2eb5cad0d
Dasyam, Ben
26c3c137-17ca-48b0-9dbe-3a41596cc650
Courtney, Helen
1088e9f5-add5-411b-a870-a456d2b8c073
White, Lucy
1858354f-abd6-48fa-a229-6ddccccbdd5a
Tedbury, Jo
7f87b54f-c9eb-437b-9292-444b34e09db4
Butt, Jane
28423c2f-2497-461b-8851-9bd52ea8a028
Newman-Taylor, Katherine
e090b9da-6ede-45d5-8a56-2e86c2dafef7
Richardson, Thomas, Dasyam, Ben, Courtney, Helen, White, Lucy, Tedbury, Jo, Butt, Jane and Newman-Taylor, Katherine
(2019)
Predictors of disengagement from cognitive behavioural therapy for psychosis in a National Health Service setting: a retrospective evaluation.
British Journal of Clinical Psychology, 58 (4), .
(doi:10.1111/bjc.12222).
Abstract
Objectives: to evaluate whether demographic and clinical variables are related to disengagement rates in cognitive behavioural therapy (CBT) for psychosis in a clinical setting.
Methods: the medical records and symptom severity data (from Health of the Nation Outcome Scales) were analysed retrospectively for 103 referrals for CBT for psychosis in a National Health Service secondary care and Early Intervention in Psychosis team.
Results: overall, 42.7% (n = 44) disengaged from CBT. There was no impact of gender or ethnicity, and no impact of clinical variables such as risk history and comorbid diagnosis. However, risk of disengagement was significantly higher for those who were younger, F = 6.89, partial η2 = .064, p = <.05; those with greater total HoNOS scores, F = 4.22, partial η2 = .04, p < .05; more severe symptoms on the HoNOS items of overactive, aggressive, disruptive, or agitated behaviour, χ2 = 6.13, p < .01; problem drinking or drug taking, χ2 = 7.65, p < .05; depressed mood, χ2 = 7.0, p < .01; and problems with occupation and activities: χ2 = 3.68, p < .05. There was a non‐significant trend for shorter waiting times to be associated with greater levels of disengagement.
Conclusions: these results indicate that it may not be psychosis per se that disrupts engagement in CBT, but linked behavioural and emotional factors. A more assertive approach to these factors – overactive, aggressive, disruptive, or agitated behaviour, problem drinking or drug taking, depressed mood, and problems with occupation and activities, particularly in younger people – may be valuable prior to or early on in therapy as a means of increasing engagement in CBT for psychosis.
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Disengagement from CBTp - ms
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Richardson et al (2019)- Predictors of dropout from CBT for psychosis
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Accepted/In Press date: 4 April 2019
e-pub ahead of print date: 10 June 2019
Published date: November 2019
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Local EPrints ID: 432089
URI: http://eprints.soton.ac.uk/id/eprint/432089
ISSN: 0144-6657
PURE UUID: 2a2160ac-bd22-4ef2-8335-02c6cfb71c3f
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Date deposited: 01 Jul 2019 16:30
Last modified: 16 Mar 2024 07:56
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Author:
Ben Dasyam
Author:
Helen Courtney
Author:
Lucy White
Author:
Jo Tedbury
Author:
Jane Butt
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