Opening the Black Box of Cognitive-Behavioural Case Management in Clients with Ultra-High Risk for Psychosis
Hartmann, Jessica A McGorry, Patrick D Schmidt, Stefanie J Amminger, G Paul Yuen, Hok Pan Markulev, Connie Berger, Gregor E Chen, Eric Y H de Haan, Lieuwe Hickie, Ian B
Hartmann, Jessica A
McGorry, Patrick D
Schmidt, Stefanie J
Amminger, G Paul
Yuen, Hok Pan
Markulev, Connie
Berger, Gregor E
Chen, Eric Y H
de Haan, Lieuwe
Hickie, Ian B
Abstract
Background Cognitive Behavioural Therapy (CBT) is the first-choice treatment in the
ultra-high risk (UHR) for psychosis group. However, CBT is an umbrella term for a
plethora of different strategies, and little is known about the association between
intensity and content of CBT and severity of symptomatic outcome.
Methods A sample of 268 UHR participants received six months of cognitive
behavioural therapy with case management (CBCM) in the context of the multi-centre
Neurapro trial with monthly assessments of attenuated psychotic symptoms (APS).
Using multilevel regressions and controlling for initial severity of APS, the association
between (1) number of CBCM sessions received and severity of APS, and (2)
specific CBCM components and severity of APS, were investigated.
Results In Month 1, a higher number of sessions and more assessment of
symptoms predicted an increase of APS, while in Month 3, a higher number of
sessions and more monitoring predicted a decrease in level of APS. More
therapeutic focus on APS predicted an increase of APS overall.
Conclusions Our findings indicate that the association between intensity/content of
CBCM and severity of APS in a sample of UHR participants depends on time in
treatment. CBCM may positively impact severity of APS later in the course of
treatment. Therefore, it would seem important to keep UHR young people engaged in
treatment beyond this initial period. Regarding the specific content of CBCM, a
therapeutic focus on APS may not necessarily be beneficial in reducing the severity
of APS, a possibility in need of further investigation.
MIDER Authors
Citations
Altmetric:
Date
2017-09-14
Type
Article
Other
Other
Subject
Mental health
Citation
Hartmann, J. A., McGorry, P. D., Schmidt, S. J., Amminger, G. P., Yuen, H. P., Markulev, C., ... & Nelson, B. Opening the Black Box of Cognitive-Behavioural Case Management in Ultra-High Risk for Psychosis Clients
Journal / Source Title
Psychotherapy and Psychosomatics
DOI
10.1159/000477551
PMID
28903120
Publisher
Karger
Publisher’s URL
https://karger.com/pps/article-abstract/86/5/292/283060/Opening-the-Black-Box-of-Cognitive-Behavioural?redirectedFrom=fulltext