Flach, C., French, P., Dunn, G., Fowler, D., Gumley, A.I. , Birchwood, M., Stewart, S.L.K. and Morrison, A.P. (2015) Components of therapy as mechanisms of change in cognitive therapy for people at risk of psychosis: analysis of the EDIE-2 trial. British Journal of Psychiatry, 207(2), pp. 123-129. (doi: 10.1192/bjp.bp.114.153320) (PMID:25999337)
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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: | Articles |
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Status: | Published |
Refereed: | Yes |
Glasgow Author(s) Enlighten ID: | Gumley, Professor Andrew |
Authors: | Flach, C., French, P., Dunn, G., Fowler, D., Gumley, A.I., Birchwood, M., Stewart, S.L.K., and Morrison, A.P. |
College/School: | College of Medical Veterinary and Life Sciences > School of Health & Wellbeing > Mental Health and Wellbeing |
Journal Name: | British Journal of Psychiatry |
Publisher: | Royal College of Psychiatrists |
ISSN: | 0007-1250 |
ISSN (Online): | 1472-1465 |
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