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Components of therapy as mechanisms of change in cognitive therapy for people at risk of psychosis: analysis of the EDIE-2 trial
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posted on 2023-06-09, 02:15 authored by Clare Flach, Paul French, Graham Dunn, David FowlerDavid Fowler, Andrew I Gumley, Max Birchwood, Suzanne L K Stewart, Anthony P MorrisonBackground 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.
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- Published
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- Published version
Journal
The British Journal of PsychiatryISSN
0007-1250Publisher
Royal College of PsychiatristsExternal DOI
Issue
2Volume
207Page range
123-129Department affiliated with
- Psychology Publications
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- No
Peer reviewed?
- Yes
Legacy Posted Date
2016-07-26First Compliant Deposit (FCD) Date
2016-07-26Usage metrics
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