Feasibility of Implementing Cognitive Behavioral Therapy for Psychosis on Assertive Community Treatment Teams: A Controlled Pilot Study

Abstract

Cognitive behavioral therapy for psychosis (CBTp) has been shown to reduce symptoms of schizophrenia, but implementation of CBTp interventions in community settings in the U.S. has not been studied. This study examined whether community case managers can effectively deliver manualized CBTp to clients with psychosis. Community case managers from assertive community treatment teams received a one-day training workshop and bi-weekly group supervision and delivered CBTp to clients with psychotic disorders in their caseload for 12 weeks. On average, only half (6 of 12) the manualized sessions were delivered. Patients who received more sessions learned more skills and had better outcomes, and greater skill learning was correlated with greater improvement in several outcomes. Case managers, on average, delivered CBTp with adequate fidelity CBTp can be effectively delivered by front-line mental health workers, but implementation barriers hindered delivery of an adequate dosage of therapy.