Evidence Base for CBTp

Researchers investigated the possible effect of Cognitive Behavioral Therapy (CBT) for auditory hallucinations on activation within the brain. They compared 17 patients with schizophrenia who received CBT for auditory hallucinations, 24 receiving treatment as usual, and 14 healthy controls with functional magnetic resonance (fMRI) imaging. They found significant reduction in several brain areas in patients receiving CBT: left and right amygdalae, left middle temporal gyrus, left superior temporal gyrus, and right superior frontal gyrus. These results suggest a biological marker of CBT effects in patients receiving treatment for auditory hallucinations [click for resource].

This article reviews evidence regarding what service users are seeking from mental health services and the ability of CBTp to meet these standards. Qualitative research within trials indicate that service users experience high satisfaction and deem treatment to be recovery-orientated, collaborative and validating when high quality CBTp is delivered by competent trial therapists. It is essential to ensure that CBTp is delivered with fidelity as well as emphasize the values of services users [click for resource].

Few CBTp implementation studies have applied a framework to CBTp implementation. The authors adapted the Learning Collaborative model in an attempt to promote adoption of CBTp in community mental health clinics across a large, populous state with poor access to mental health services. Fifty-six providers attended an in-person training followed by six months of biweekly consultation sessions (Phase 1). Twenty-one providers participated in an additional six months of consultation (Phase 2). One year after completion of Phase 2, 21% of the originally trained providers continue to provide CBTp. Penetration and self-perceived skill development were improved modestly. Participating providers identified multiple barriers to CBTp implementation, including features of the training and consultation, the agency, the intervention itself, and psychosocial and clinical challenges associated with the client population.[click for resource].

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