COVID Leading to Secondary Mental Health Pandemic

The COVID pandemic is now leading to the emergence of a secondary mental health pandemic. Clients with psychosis are at increased risk of poorer medium- and long-term psychosocial and clinical outcomes. In response to the pressing need to flexibly deliver high-quality care to individuals with psychosis, this brief report proposes high yield cognitive behavioral techniques for psychosis (HY-CBt-p) facilitated by task sharing and digital enhancements. Previous research suggests that effect sizes will be lower than that of 16-session formulation-driven CBTp, but additional research is needed to test the feasibility, acceptability, efficacy, and comparative effectiveness of different forms of remote-delivered CBTp.

PART 1: Supporting CBT Clients During COVID-19

Access a 2-part clinical tip sheet prepared by the University of Washington CBTp Implementation Team on the remote administration of CBTp. Part 1 focuses on Best Practices in TeleCBTp.

PART 2: Supporting CBT Clients During COVID-19

Part 2 shares Key Intervention Targets and Strategies to consider, and can be accessed HERE. Access to the recorded didactics that are intended to accompany these materials are also available by request, by emailing cbtECHO@uw.edu.

Cognitive Behavioral Therapy for Psychosis (CBTp)

This fact sheet written by Dr. Kate Hardy provides an explanation of CBT, CBT for psychosis, and early intervention principles as it relates to CBTp; a case example of using CBTp with a client presenting with concerns related to auditory hallucinations; and training requirements for clinicians who are interested in practicing CBTp. It was developed for SAMHSA/CMHS under Contract Reference: HHSS283201000021/Task Order No. HHSS28342002T.

Stepped Care Model for CBT for Psychosis

Cognitive behavioral therapy for schizophrenia spectrum disorders is an evidence-based treatment that is recommended by United States schizophrenia treatment guidelines. Based on recent estimates, only 0.3% of individuals with a primary psychotic disorder are able to access this treatment in the United States. Stepped care interventions have shown promise as an applied treatment delivery model in other settings and for other psychotherapeutic interventions. The current paper describes how the stepped care model can be applied to CBT for psychosis in the US to increase access to the intervention in community mental health settings by leveraging the multidisciplinary team.

Statewide Implementation of CBTp Through a Learning Collaborative Model

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).

A Systematic Review of CBT Approaches to Delusions and Hallucinations

While CBTp has been established as an evidence-based treatment for psychosis, most randomized controlled trials (RCTs) take a broad approach in designing CBTp interventions, given the significant heterogeneity of psychotic symptoms. There may be utility in looking at more symptom-specific, tailored CBTp interventions. This paper reviews effect sizes from CBTp interventions in RCTs that specifically targeted either persecutory delusions or auditory hallucinations, and identifies some that are particularly efficacious.