Components of therapy as mechanisms of change in cognitive therapy for people at risk of psychosis: An analysis of the EDIE-2 trial

Hdl Handle:
http://hdl.handle.net/10034/337035
Title:
Components of therapy as mechanisms of change in cognitive therapy for people at risk of psychosis: An analysis of the EDIE-2 trial
Authors:
Flach, Clare; French, Paul; Dunn, Graham; Fowler, David; Gumley, Andrew I.; Birchwood, Max; Stewart, Suzanne L. K.; Morrison, Anthony P.
Abstract:
Background: Research suggests that the way in which cognitive therapy is delivered is an important factor in determining outcomes. We test the hypotheses that the development of a shared problem list, use of case formulation, homework tasks and active intervention strategies will act as process variables. Methods: 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 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.
Affiliation:
University of Manchester ; Greater Manchester West NHS Foundation Trust/Liverpool University ; University of Manchester ; University of Sussex ; University of Glasgow ; University of Warwick ; University of Chester ; Greater Manchester West NHS Foundation Trust/University of Manchester
Journal:
British Journal of Psychiatry
Publication Date:
21-May-2015
URI:
http://hdl.handle.net/10034/337035
DOI:
10.1192/bjp.bp.114.153320
Additional Links:
http://bjp.rcpsych.org
Type:
Article
Language:
en
Description:
This is an author-produced electronic version of an article accepted for publication in the British Journal of Psychiatry. The definitive publisher-authenticated version is available online at http://bjp.rcpsych.org
ISSN:
0007-1250
EISSN:
1472-1465
Appears in Collections:
Psychology

Full metadata record

DC FieldValue Language
dc.contributor.authorFlach, Clareen
dc.contributor.authorFrench, Paulen
dc.contributor.authorDunn, Grahamen
dc.contributor.authorFowler, Daviden
dc.contributor.authorGumley, Andrew I.en
dc.contributor.authorBirchwood, Maxen
dc.contributor.authorStewart, Suzanne L. K.en
dc.contributor.authorMorrison, Anthony P.en
dc.date.accessioned2014-12-10T17:37:38Zen
dc.date.available2014-12-10T17:37:38Zen
dc.date.issued2015-05-21en
dc.identifier.issn0007-1250en
dc.identifier.doi10.1192/bjp.bp.114.153320en
dc.identifier.urihttp://hdl.handle.net/10034/337035en
dc.descriptionThis is an author-produced electronic version of an article accepted for publication in the British Journal of Psychiatry. The definitive publisher-authenticated version is available online at http://bjp.rcpsych.orgen
dc.description.abstractBackground: Research suggests that the way in which cognitive therapy is delivered is an important factor in determining outcomes. We test the hypotheses that the development of a shared problem list, use of case formulation, homework tasks and active intervention strategies will act as process variables. Methods: 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 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.en
dc.language.isoenen
dc.relation.urlhttp://bjp.rcpsych.orgen
dc.subjecttherapyen
dc.titleComponents of therapy as mechanisms of change in cognitive therapy for people at risk of psychosis: An analysis of the EDIE-2 trialen
dc.typeArticleen
dc.identifier.eissn1472-1465en
dc.contributor.departmentUniversity of Manchester ; Greater Manchester West NHS Foundation Trust/Liverpool University ; University of Manchester ; University of Sussex ; University of Glasgow ; University of Warwick ; University of Chester ; Greater Manchester West NHS Foundation Trust/University of Manchesteren
dc.identifier.journalBritish Journal of Psychiatryen
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