Key Components for the Delivery of Cognitive Behavioral Therapies for Psychosis in Acute Psychiatric Inpatient Settings: A Delphi Study of Therapists’ Views

Abstract

Abstract Cognitive Behavioral Therapy for psychosis (CBTp) is a psychological therapy recommended for people with psychosis which can start in the acute phase. However, there is not consensus on how CBTp should be delivered in an acute mental health inpatient setting. This study aimed to gain consensus from therapists on how CBTp should be delivered in this context. A 2-stage Delphi study was conducted to establish consensus on what the core components are of inpatient CBTp from the perspective of therapists who are experts in the field. Forty-five therapists took part in 2 rounds of rating statements on the areas of engagement and feedback, assessment and model, formulation, change strategies, homework, and principles and values. A final list of 114 statements were included, which were rated as essential or important by ≥80% of respondents. The delivery of inpatient CBTp is dependent on several adaptations to traditional CBTp including indirect work, being more flexible with session content and delivery, and making adaptations to the restrictive environment. These recommendations could inform training, competency frameworks, and delivery of CBTp in inpatient settings.