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Measuring adherence in social recovery therapy with people with first episode psychosis

Published online by Cambridge University Press:  05 August 2019

Christine Lowen
Affiliation:
Norfolk and Suffolk Mental Health Foundation Trust, Norwich, UK
Jo Hodgekins*
Affiliation:
Department of Clinical Psychology, Norwich Medical School, University of East Anglia, Norwich, UK
Katherine Pugh
Affiliation:
Sussex Partnership NHS Foundation Trust, Worthing, UK
Clio Berry
Affiliation:
Sussex Partnership NHS Foundation Trust, Worthing, UK University of Sussex, Brighton, UK
Mike Fitzsimmons
Affiliation:
Lancashire Care NHS Foundation Trust, Preston, UK
Paul French
Affiliation:
Psychosis Research Unit, Greater Manchester Mental Health NHS Trust, Manchester, UK Institute of Health and Psychology, University of Liverpool, Liverpool, UK
Catarina Sacadura
Affiliation:
Sussex Partnership NHS Foundation Trust, Worthing, UK
Max Birchwood
Affiliation:
University of Warwick, Warwick, UK
Chris Jackson
Affiliation:
Birmingham Women’s and Children’s NHS Foundation Trust, Birmingham, UK
Eleanor Baggott
Affiliation:
Canterbury District Health Board, Christchurch, New Zealand
Mark Bernard
Affiliation:
Birmingham Women’s and Children’s NHS Foundation Trust, Birmingham, UK
David Fowler
Affiliation:
University of Sussex, Brighton, UK
*
*Corresponding author. Email: j.hodgekins@uea.ac.uk

Abstract

Background:

The SUPEREDEN3 study, a phase II randomized controlled trial, suggests that social recovery therapy (SRT) is useful in improving functional outcomes in people with first episode psychosis. SRT incorporates cognitive behavioural therapy (CBT) techniques with case management and employment support, and therefore has a different emphasis to traditional CBT for psychosis, requiring a new adherence tool.

Aims:

This paper describes the SRT adherence checklist and content of the therapy delivered in the SUPEREDEN3 trial, outlining the frequency of SRT techniques and proportion of participants who received a full therapy dose. It was hypothesized that behavioural techniques would be used frequently, consistent with the behavioural emphasis of SRT.

Method:

Research therapists completed an adherence checklist after each therapy session, endorsing elements of SRT present. Data from 1236 therapy sessions were reviewed to determine whether participants received full, partial or no therapy dose.

Results:

Of the 75 participants randomized to receive SRT, 57.3% received a full dose, 24% a partial dose, and 18.7% received no dose. Behavioural techniques were endorsed in 50.5% of sessions, with cognitive techniques endorsed in 34.9% of sessions.

Conclusions:

This report describes an adherence checklist which should be used when delivering SRT in both research and clinical practice. As hypothesized, behavioural techniques were a prominent feature of the SRT delivered in SUPEREDEN3, consistent with the behavioural emphasis of the approach. The use of this adherence tool would be considered essential for anyone delivering SRT looking to ensure adherence to the model.

Type
Main
Copyright
© British Association for Behavioural and Cognitive Psychotherapies 2019 

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