Components of therapy as mechanisms of change in cognitive therapy for people at risk of psychosis: analysis of the EDIE-2 trial

Flach, Clare, French, Paul, Dunn, Graham, Fowler, David, Gumley, Andrew I, Birchwood, Max, Stewart, Suzanne L K and Morrison, Anthony P (2015) Components of therapy as mechanisms of change in cognitive therapy for people at risk of psychosis: analysis of the EDIE-2 trial. The British Journal of Psychiatry, 207 (2). pp. 123-129. ISSN 0007-1250

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Abstract

Background

Research suggests that the way in which cognitive therapy is delivered is an important factor in determining outcomes. We test the hypotheses in which the development of a shared problem list, use of case formulation, homework tasks and active intervention strategies will act as process variables.

Method

Presence of these components during therapy is taken from therapist notes. The direct and indirect effect of the intervention is estimated by an instrumental variable analysis.

Results

A significant decrease in the symptom score for case formulation (coefficient = −23, 95% CI −44 to −1.7, P = 0.036) and homework (coefficient = −0.26, 95% CI −0.51 to −0.001, P = 0.049) is found. Improvement with the inclusion of active change strategies is of borderline significance (coefficient = −0.23, 95% CI −0.47 to 0.005, P = 0.056).

Conclusions

There is a greater treatment effect if formulation and homework are involved in therapy. However, high correlation between components means that these may be indicators of overall treatment fidelity.

Item Type: Article
Schools and Departments: School of Psychology > Psychology
Subjects: B Philosophy. Psychology. Religion
Depositing User: Alexandra Barnard
Date Deposited: 26 Jul 2016 08:11
Last Modified: 08 Mar 2017 04:57
URI: http://sro.sussex.ac.uk/id/eprint/62095

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