# An exploratory study of the relevance of therapy format and therapist’ training in individual cognitive behavioral therapy for psychosis

## TL;DR

This study explores whether different formats and therapist training levels affect the outcomes of cognitive behavioral therapy for psychosis.

## Contribution

The study investigates the scalability of CBTp by comparing different delivery formats and therapist training levels.

## Key findings

- All groups showed improvements in functioning and symptom levels.
- No significant differences were found between CBTp delivery formats or therapist training levels.

## Abstract

Cognitive Behavioral Therapy for psychosis (CBTp) is an evidence-based intervention that can be delivered in various formats, including as part of vocational rehabilitation. However, due to scarcity of resources, CBTp is currently accessible to only a minority of individuals with psychosis. This secondary analysis aims to explore potential differences in clinical outcomes between distinct CBTp formats and to examine whether therapist training influences treatment effect. Exploring these aspects is of importance, as they may influence the scalability and accessibility of CBTp in routine care.

Data in this study is sourced from two independent projects; KATOslo and JUMP, comprising a total of 200 participants with broad schizophrenia-spectrum disorders. The current study compares CBTp delivered as either symptom-focused individual therapy (KATOslo) or as an add-on to a vocational rehabilitation (VR) program (JUMP), with two reference groups; VR combined with cognitive remediation (JUMP) and treatment as usual (KATOslo). Using a series of mixed effects models for repeated measurements, we examined differences between the groups in terms of general functioning and psychiatric symptom severity. Emphasis was placed on potential differences between the two groups receiving CBTp, considering both average differences across assessment points and trajectories over time.

In line with expectations, all groups demonstrated overall improvements in functioning and symptom levels. After adjusting for relevant confounders, no statistically significant differences were found between the two groups receiving CBTp following treatment initiation.

These findings suggest that CBTp may be effective across different delivery formats and levels of therapist training in terms of similar, positive clinical outcomes for this patient group. This has potential implications for service design and broader implementation of CBTp in real-world settings.