1. Researchers develop psychotherapy treatment for refugees’ trauma

    November 13, 2017 by Ashley

    From the Bielefeld University press release:

    They are suffering from nightmares, flashbacks, depression, or anxiety disorders: refugees coming to Germany from conflict areas are frequently traumatized. ‘Realistic estimates state that up to 40 per cent of refugees have mental problems. Hence, for the period since 2015, we are talking about several hundred thousand people who are in real need of psychological support,’ says Professor Dr. Frank Neuner from Bielefeld University. The psychologist is one of the team responsible for developing ‘Narrative Exposure Therapy’ (NET). It has been applied over the last 15 years in conflict zones from East Africa to Sri Lanka. What is special about this therapy is that it shows success after only a few sessions. In a new ‘research_tv’ programme at Bielefeld University, Frank Neuner talks about NET and explains the consequences of leaving refugees without treatment.

    ‘I believe that a large part of the general population is willing to accept that we now need to invest substantially in dealing with these traumatized refugees and that the state must make money available for this,’ says Frank Neuner. ‘Due to the threats in their home countries, many refugees will be staying with us for a long time. By helping them now, we shall be warding off problems that will otherwise confront us unavoidably in 20 or 30 years time.’

    Neuner designed and tested NET together with Dr. Maggie Schauer and Professor Dr. Thomas Elbert from the University of Konstanz. By working with this method, hundreds of child soldiers, victims of political violence, and war refugees have been able to process their traumatic experiences.

    The key principle of NET is a highly valued practice in every culture: telling stories. ‘Whenever we have gone through an emotional experience, we try to tell stories. This is how we try to make what we have experienced comprehensible to others,’ says Neuner. ‘Refugees have experienced a whole series of traumatic events. We talk together with them about their entire life history and build up a kind of autobiography that enables them to embed the single traumatic experiences in a meaningful context and work out the significance they have in their own personal lives.’ Together with their therapist, traumatized persons work their way repeatedly and chronologically through the negative and positive events in their lives. ‘The idea is to historicize the traumatic events. This permits closure, so that they no longer threaten the present.’

    To deliver therapy to people in crisis zones, Neuner together with colleagues from the University of Konstanz and further supporters founded the aid organisation ‘Vivo’. It is training lay therapists in countries such as Sri Lanka, Ruanda, Uganda, and the Congo. Unlike Germany, the health systems of these countries do not provide access to professional therapists. ‘However, even Germany does not have enough therapists to treat all the refugees with traumatic disorders. Many people in Germany already have to wait months for a treatment slot with a therapist,’ says Neuner. ‘One step towards a solution could be to give NET training to refugees and migrants here in Germany and to employ them within a stepped care model supervised by psychotherapists. However, the German legal situation does not permit this at present.’

    NET is already being practiced by professional therapists in Germany. Bielefeld University’s psychotherapy clinic is applying the method in therapy studies not only refugees with but also with survivors of child abuse, rape victims, and former members of the German military. The scientific further education centres at Bielefeld University and the University of Konstanz are qualifying psychologists, medical doctors, and psychotherapists to work with NET.


  2. Study shows clear effect of art therapy on severe depression

    November 10, 2017 by Ashley

    From the University of Gothenburg press release:

    Create a picture of how you are feeling on this particular day, said the first exercise in the art therapy. After ten treatments the patients who suffered from severe or moderately severe depression had shown more improvement than the patients in the control group, shows research at Sahlgrenska academy.

    “The conclusion is that it was the art therapy that facilitated their improvement,” says Christina Blomdahl, PhD at the institute of health and care sciences, licensed occupational therapist and art therapist.

    As part of her dissertation she has allowed 43 patients with severe or moderately severe depression to undergo a manual-based art therapy that she has developed herself. The control group consisted of 36 people who all suffered from the same medical condition.

    In parallel with this, all participants were given different combinations of medication, cognitive behavioral therapy, psychodynamic therapy and physical therapy. The majority of the participants were so affected by their depression that they were unable to work.

    The individual art therapy took place in psychiatry or primary care and was conducted by a specially trained therapist. Each session began with a short briefing and a relaxation exercise. After that it was crayons, water colors and creation that was on the agenda, all based on a predetermined setup.

    “They followed the manual I had created in order to ensure that it was scientific, but although everyone was given the same theme to go on the patients responded very differently to the exercises. The materials were simple, allowing people to doodle and feel free to express themselves the way they wanted to, and then they would talk about the picture and its significance to the participant,” explains Christina Blomdahl.

    After ten hour-long treatment sessions the patients had improved on an average of almost five steps on a rating scale used for depression. A large leap that entails a considerable change to everyday life, and sometimes it may also mean that a patient is able to return to work.

    Anxiety, sleep, ability to take initiative and emotional involvement are some of the factors that are assessed. In the control group that had not undergone art therapy there was no definite change.

    “The focal point was that people felt like they were meeting themselves; that the picture served as a mirror where you could see and make new discoveries about yourself, a bit like coming to life, says Christina Blomdahl.

    “Even the people who did not experience any direct benefit from the treatment had shown improvement. Painting pictures based on themes and discussing the pictures with the therapist promotes self-reflection and brain stimulation that takes place outside of the conscious mind,” she continues.

    “It is my hope that art therapy will be used in healthcare again. Based on evidence requirements it has been more or less scrapped by psychiatry, but this is one of the largest studies that has been conducted in this area and it is a step that may lead to more people being trained in it and the method being used again,” Christina Blomdahl concludes.

    Further information: https://gupea.ub.gu.se/handle/2077/52419


  3. Researchers develop set of guidelines for art therapy for children with ASD

    August 9, 2017 by Ashley

    From the Florida State University press release:

    A Florida State University researcher is working with art therapists to find better ways to treat children who have Autism Spectrum Disorder (ASD).

    Theresa Van Lith, assistant professor of art therapy in FSU’s Department of Art Education, led a study that surveyed art therapists working with children with ASD to develop a clearer understanding of their techniques and approaches. The study was published this month in the journal Arts in Psychotherapy.

    “I had noticed that is there is a high number of art therapists working with people who have autism, but I wanted to understand what their practice wisdoms were in terms of how they go about facilitating art therapy sessions,” Van Lith said. “We want to make it a transparent process for the client or the parents of a client, so they know what to expect.”

    The Center for Disease Control and Prevention estimates that one in 68 children is diagnosed with Autism Spectrum Disorder by age 8 each year. As that population grows, more parents and educators are seeking out art therapists to address social development and sensory issues that generally accompany ASD.

    The research team compiled and analyzed the art therapists’ expert opinions on topics such as what worked with ASD clients, their objectives during a session, their most preferred theoretical approach and the considerations they had to make when working with children with ASD.

    “We realized there wasn’t a consensus with the theoretical approaches they used,” Van Lith said. “They were having to use a number of theoretical approaches together, and we wanted to understand what that would be like in practice.”

    While the survey results varied, the researchers were able to develop a set of guidelines for delivering art therapy to children who have ASD. The proposed guidelines will serve as a basis of successful practice for new art therapy professionals and for further studies.

    “We used these practice wisdoms from art therapists around the field to understand the most effective and beneficial way to use art therapy with child with ASD,” Van Lith said.

    Some of the best practices found were: use the same routine to begin each session, explain instructions in a consistent manner, spark curiosity to teach new skills and be aware of transitions between activities.

    The researchers also outlined aspects of practice that were found not to be useful. They warned art therapists on a handful of factors that could have adverse effects on clients such as being overly directive or too loose with direction, using over stimulating art materials and forcing or being restrictive with communication styles.

    “That’s important because sometimes there is the assumption of ‘why can’t anyone do these techniques?'” Van Lith said. “People wonder why art therapy can’t be conducted in a much less formal situation. However, they don’t realize there are nuances in the way we deliver the art therapy directive — a lot of that is about knowing the client and the way a client responds to communication.”

    Based on these guidelines and consensus, Van Lith is rolling out a larger study to demonstrate the efficacy of that working model.

    “The idea is that, over time, we can build up the evidence that art therapy is effective for these children, and we can demonstrate how and why that is the case,” Van Lith said.

    The ultimate goal is to educate art therapists about best practices as well as inform clients, parents and teachers about possible benefits of art therapy for children with ASD.

    “As a result of more transparency, the clients can appreciate or understand some of the changes that might be going on for them as they receive art therapy,” Van Lith said. “We don’t want it to be a mysterious process.”

    Van Lith co-authored the study with Jessica Stallings, associate professor at Emporia State University, and FSU alumna Chelsea Harris, who practices at the Emory Autism Center.


  4. Study suggests cognitive behavioral therapy improves functioning for people with chronic pain

    July 29, 2017 by Ashley

    From the American Pain Society press release:

    Cognitive Behavioral Therapy (CBT) is the most frequently used psychological intervention for people with chronic pain, and new approaches for improving CBT outcomes may be found in the psychological flexibility model and Acceptance and Commitment therapy (ACT), according to research reported in The Journal of Pain.

    Acceptance and Commitment Therapy (ACT) is based on the psychological flexibility model, which includes a therapeutic process known as “self-as-context” (SAC). Contextual self refers to a sense of self that is not based on self-evaluations. It is similar to being an observer of one’s own psychological experiences. Researchers in the United Kingdom writing in The Journal of Pain examined whether ACT influences SAC and if changes in measures of SAC are associated with treatment outcomes.

    Psychological flexibility is the ability to be more aware, more focused on goals and more engaged. Another aspect of psychological flexibility pertinent to chronic pain, and supported by SAC, is called committed action, which involves goal-directed, flexible persistence,” said co-author Lance M. McCracken, Professor of Behavioral Medicine, Institute of Psychiatry, Psychology and Neuroscience, Kings College London. “For pain management, ACT is an approach based on the psychological flexibility model and focuses on building effective patterns of behavior change rather than symptom reduction.”

    Four hundred twelve adults referred to a pain management center at Guy’s and St. Thomas’ Hospital in London were subjects for the study. They completed measures of treatment processes, such as SAC and committed action, and outcomes (pain-related interference, work and social adjustment, depression) before treatment, upon treatment completion and after nine months.

    Wider outcomes research suggests that ACT is effective for enhancing daily functioning and for decreasing psychological distress. A study published in 2011 assessed the long-term efficacy of acceptance and commitment therapy in more than 100 people with chronic pain. The evidence showed at three-year follow-up that 65 percent of study subjects had reliably improved in at least one key clinical domain, and improvements in psychological flexibility were associated with improvements in outcomes measures.

    Results of the current Kings College study showed that scores from both the process and outcomes measures significantly improved after treatment and were maintained at nine-month follow-up. The ACT-oriented treatment was associated with improved SAC as well as improved functioning. Changes in SAC were associated with changes in pain-related interference, work and social adjustment and depression.

    Greater psychological flexibility is associated with less pain-related anxiety and avoidance, less depression, less physical and psycho-social disability and other measures of patient function,” said McCracken. “Based on studies of forms of CBT that did not include ACT, acceptance of pain, one component of psychological flexibility, may be a general mechanism by which CBT treatments achieve improvements in functioning, and more specific targeting of pain-related acceptance may lead to further improvement is CBT outcomes.”

    The authors concluded that that the study results are consistent with an increasing number of longitudinal and mediation studies showing that ACT for chronic pain improves patient functioning, specifically through enhanced psychological flexibility.


  5. Study examines line between education and personal experience in the classroom

    June 29, 2017 by Ashley

    From the Concordia University press release:

    In the classroom, what’s the line between education and personal experience?

    This is a question addressed by Concordia alumnus Jason Butler (PhD 14) in an article recently published by The Arts in Psychotherapy.

    In the course of a North American and UK study, he found that the conflicting demands of education and therapy within the classroom can cause emotional stress and confusion among students in drama therapy and other professions using dramatic enactment.

    His conclusion? The use of personal material must be better defined to protect both students and faculty.

    “When educating therapists, particularly using experiential methods, things can become blurry,” Butler notes.

    “Instructors often take for granted that doing role-plays or other enactments within the classroom are relatively benign acts. However, this research shows that material can resonate with students in complex ways that often inhibit their learning and development.”

    Butler’s study offers eight recommendations for improving the practice of drama therapy education.

    These include increased transparency between teachers and students; clearer policies on the use of affective material in the classroom; guidelines for evaluating and assessing emotional performance; and discussions within the professions about ethical and pedagogical practices.

    “These findings point us in in the direction of creating better systems and pedagogical approaches to enhance the student experience and educate more effective therapists.”

    The impact of self-regulation

    In the study, students reported that they were asked to incorporate personal material into their assignments with the caveat that they avoid anything overwhelming.

    The expectation of self-regulation without clear guidelines for evaluating what was appropriate created stress and uncertainty.

    Some students also found the transition from mock therapy to teaching jarring, as it left emotional impacts insufficiently addressed or resolved. Others experienced uncertainty over how or if their emotional engagement would be graded.

    For example, in a teaching demonstration an instructor might ask a student to assume the role of a trauma survivor without knowing they have direct experience as such. The student may feel obliged to engage with potentially harmful material in an inappropriate setting due to classroom pressure and the potential for evaluation.

    Butler is quick to point out that affect is not the problem, however.

    Affective engagement can be a powerful tool for facilitating learning,” he notes.

    “Research has shown that therapists who are more aware of their own emotional experience are better equipped to work with the emotional experiences of their clients. The challenge here is to channel that affect in a responsible and transparent manner.”

    Better systems and pedagogical approaches

    Butler conducted interviews and focus groups with students and faculty members at three drama therapy training programs in North America and the United Kingdom.

    The data was sorted into themes and coded inductively to form a larger picture or research model of the student experience of affective engagement in the classroom.

    That model showed that students wrestle with expectations regarding the appropriate level of engagement. This often leads to strong emotional responses in the classroom, which in turn lead to negative consequences. Some students leave or fail out of the program; it is recommended that all seek therapy.

    For Butler, the findings suggest that more transparent communication is required between teachers and students.

    “Without an understanding of the processes at play, we are not able to capitalize on the strengths that come from these approaches to learning.”


  6. Study examines effect of CBT on chronic pain patients

    June 26, 2017 by Ashley

    From the European League against Rheumatism press release:

    The results of a study presented today at the Annual European Congress of Rheumatology (EULAR) 2017 has shown that Acceptance and Commitment Therapy, a form of cognitive behavioural therapy (CBT) that focuses on psychological flexibility and behaviour change, provided a significant reduction in self-reported depression and anxiety among patients participating in a pain rehabilitation programme.

    This treatment also resulted in significant increases in self-efficacy, activity engagement and pain acceptance.

    To assess the potential benefits of an 8-week programme of group Acceptance and Commitment Therapy (ACT) in people with persistent pain, measures of pain acceptance and activity engagement were taken using the Chronic Pain Acceptance Questionnaire. Measures of psychological distress using the Hospital Anxiety and Depression Scale and self-efficacy were also taken at assessment, on the final day of the programme, and at the follow up six-month review.

    For those chronic pain patients with scores at all three time points, there were statistically significant improvements in all parameters between baseline and at six-months follow-up, including the change in mean score of depression, anxiety, self-efficacy, activity engagement and pain willingness (p<0.001).

    “To further validate the role of ACT in the treatment of chronic pain, specifically in a rheumatology context, a randomised controlled clinical trial that includes measures of physical and social functioning within a Rheumatology service would be desirable,” said lead author Dr. Noirin Nealon Lennox from Ulster University in Northern Ireland.

    ACT is a form of CBT that includes a specific therapeutic process referred to as “psychological flexibility”. ACT focuses on behaviour change consistent with patients’ core values rather than targeting symptom reduction alone. Evidence for this approach to the treatment of chronic pain has been mounting since the mid 2000’s. A previous systematic review had concluded that ACT is efficacious for enhancing physical function and decreasing distress among adults with chronic pain attending a pain rehabilitation programme.

    In this study, patients were referred into the ACT programme by three consultant rheumatologists over a five-year period. Over one hundred patients’ outcome measures were available for a retrospective analysis.


  7. Study suggests cognitive behavioral therapy could help stress in sport

    May 21, 2017 by Ashley

    From the Leeds Beckett University press release:

    Cognitive behavioural therapy (CBT) could be a powerful tool to help elite sportspeople improve their performance by handling stress more effectively, new research has found.

    The study, by Leeds Beckett and Loughborough Universities, is the first to show that CBT can change how high-level athletes respond to organizational stress within their sport, and that this can have significant benefits for their emotions and performance.

    Sport psychology researcher, Dr Faye Didymus, worked with four high-level female hockey players over nine months, using a CBT technique called cognitive restructuring to help them identify what put them under pressure, understand how they responded emotionally, and then consider more helpful alternative responses. The results were immediate: things that they had viewed as threats, players began to see instead as challenges, resulting in more positive emotions and higher satisfaction with their performance.

    Dr Didymus, from the Carnegie Research Institute at Leeds Beckett University, said: “Cognitive restructuring can help people take control of what they think about stress, which is incredibly empowering. This is particularly true in sport where individuals have to perform under pressure, either alone or as part of a team. CBT has been used in health and business settings to improve individuals’ wellbeing and performance but it’s wider use in sport is long overdue.”

    The players were from the Investec Women’s Hockey League, which, although amateur, includes the top teams in England, with players selected from the League to compete at international level. Although most players are also working or studying full-time, teams can have up to five training sessions and two competitive matches each week.

    Selection and deselection from their team and the presence of England selectors at a big game were some of the causes of stress — known as ‘stressors’ — identified by the players during the research. Others included lack of communication from the coach, issues with teammates or training, large crowds at matches and poor umpire decisions.

    The players were assessed before the CBT began to identify those who would be most likely to benefit from the programme. Each player then took part in an in-depth personalised programme of CBT to help them understand their current thoughts about stress, associated emotions, and how these might be changed by CBT. For example, for a player who was thinking ‘I must play well or I will ruin my chance of selection,’ an alternative would be suggested, such as: ‘If I play well, I’ve a good chance of being selected,’ which views selection as a challenge rather than a threat. Players would then be asked to think about how this different thought might change their feelings or emotions.

    Over the nine months, the players moved from considering these alternative responses theoretically and in discussion with Dr Didymus to coming up with their own ‘alternatives’ and integrating those into their thought processes whenever they trained or competed.

    An immediate positive impact was seen on all of the stress-related variables that Dr Didymus targeted: the players started to view more stressors as challenges than threats, positive emotions predominated, and the players’ performance satisfaction began to increase. When the players were assessed three months after the programme, these benefits had been maintained.

    One of the players who took part in the research explained her experiences as follows: ‘If I’m thinking about stressors as a challenge not a threat then I play better. I learnt how to see things as a challenge, which has helped my performance.’ Another said: ‘I practice thought adjustment in training like I do my hockey so it comes naturally in matches and nine times in ten I’m more satisfied with how I perform.’

    Given the success of the trial, Dr Didymus believes that the programme she’s developed should now be adapted and tested across a range of sports: “Ours was a small trial in one sport so we now need to see if this can replicated in other sports with the same positive effects,” she said. “We’d also like to integrate objective measures of performance within future trials, and to look at how improving individuals’ responses to stress can benefit the team as a whole.”


  8. APA study suggests patients more likely to refuse drug therapy than psychotherapy for mental health

    March 23, 2017 by Ashley

    From the American Psychological Association press release:

    People seeking help for mental disorders are more likely to refuse or not complete the recommended treatment if it involves only psychotropic drugs, according to a review of research published by the American Psychological Association.

    Researchers conducted a meta-analysis of 186 studies of patients seeking help for mental health issues that examined whether they accepted the treatment that was recommended and if they did, whether they completed it. Fifty-seven of the studies, comprising 6,693 patients, had a component that reported refusal of treatment recommendations, and 182 of the studies, comprising 17,891 patients, had a component reporting premature termination of treatment.

    After diagnosis, patients in the studies were recommended to drug-only therapy (pharmacotherapy), talk therapy (psychotherapy) or a combination of the two.

    “We found that rates of treatment refusal were about two times greater for pharmacotherapy alone compared with psychotherapy alone, particularly for the treatment of social anxiety disorder, depressive disorders and panic disorder,” said lead researcher Joshua Swift, PhD, of Idaho State University. “Rates of premature termination of therapy were also higher for pharmacotherapy alone, compared with psychotherapy alone, particularly for anorexia/bulimia and depressive disorders.”

    The research was published in the APA journal Psychotherapy.

    Across all the studies, the average treatment refusal rate was 8.2 percent. Patients who were offered pharmacotherapy alone were 1.76 times more likely to refuse treatment than patients who were offered psychotherapy alone. Once in treatment, the average premature termination rate was 21.9 percent, with patients on drug-only regimens 1.2 times more likely to drop out early. There was no significant difference for refusal or dropout rates between pharmacotherapy alone and combination treatments, or between psychotherapy alone and combination treatments.

    While Swift said the findings overall were expected, the researchers were most surprised by how large the differences were for some disorders. For example, patients diagnosed with depressive disorders were 2.16 times more likely to refuse pharmacotherapy alone and patients with panic disorders were almost three times more likely to refuse pharmacotherapy alone.

    The findings are especially interesting because, as a result of easier access, recent trends show that a greater percentage of mental health patients in the U.S. are engaging in pharmacotherapy than psychotherapy, according to co-author Roger Greenberg, PhD, SUNY Upstate Medical University.

    Some experts have argued that psychotherapy should be the first treatment option for many mental health disorders. Those arguments have been largely based on good treatment outcomes for talk therapy with fewer side effects and lower relapse rates, said Greenberg. “Our findings support that argument, showing that clients are more likely to be willing to start and continue psychotherapy than pharmacotherapy.”

    Swift and Greenberg theorized that patients may be more willing to engage in psychotherapy because many individuals who experience mental health problems recognize that the source of their problems may not be entirely biological.

    “Patients often desire an opportunity to talk with and work through their problems with a caring individual who might be able to help them better face their emotional experiences,” said Greenberg. “Psychotropic medications may help a lot of people, and I think some do see them as a relatively easy and potentially quick fix, but I think others view their problems as more complex and worry that medications will only provide a temporary or surface level solution for the difficulties they are facing in their lives.”

    While the meta-analysis provides information on refusal and dropout rates, the studies did not report the patients’ reasons for their actions, Swift noted. Going forward, research designed to identify these reasons could lead to additional strategies to improve initiation and completion rates for both therapies, he said. It is also important to note that participants in the research studies initially indicated they were willing to be assigned to any therapy, and therefore may not be representative of all consumers of treatment.


  9. Study suggests emotion-focused therapy may help with binge eating disorder

    May 31, 2013 by Ashley

    From the Journal of Psychotherapy and Psychosomatics press release via AlphaGalileo:

    food choicesThe combination of psychotherapy with dietary counseling (DC) might be a potential useful strategy to improve both eating disorder psychopathology and body weight in patients with BED.

    Recent research seems to support a model of binge eating that includes emotional vulnerability and a deficit of skills that functionally modulate negative emotions, a mechanism not directly addressed by both cognitive behavior and interpersonal psychotherapy.

    Emotion-focused therapy (EFT) is a psychological treatment designed to address the cognitive and interpersonal experiential perspective of emotions.

    We report the results of a naturalistic study that evaluated the effect of EFT , DC to reduce the consumption of energy-dense food, and combined treatment (CT) in treatment-seeking patients with BED and obesity. 189 patients who met DSM-IV research criteria for BED were included in the study. Participants received EFT administered via 20 group sessions. A proportion of cases between 44.4% and 74.6% achieved the 5% weight loss target by the end of treatment, depending on the type of treatment. CT was superior to other treatments.

    At the 6-month follow-up, EFT, either alone or in combination with DC, significantly increased the outcome rate.

    From a clinical point of view, our results show that EFT, a psychotherapy focused on the cognitive and interpersonal experiential perspectives of emotions associated with DC, produces promising results on binge eating remission, weight loss, binge eating behavior and health-related quality of life in treatment-seeking BED patients with obesity.

    The data also suggest that the combination of EFT and DC might be a promising strategy to produce both an improvement of the eating disorder psychopathology and a healthy amount of weight loss.


  10. Study suggests early cognitive behavioural therapy reduces risk of psychosis

    April 22, 2013 by Ashley

    From the University of Manchester press release via HealthCanal:

    childhood depressionYoung people seeking help who are at high risk of developing psychosis could significantly reduce their chances of going on to develop a full-blown psychotic illness by getting early access to cognitive behavioural therapy (CBT), new research shows.

    Researchers from The University of Manchester found the risk of developing psychosis was more than halved for those receiving CBT at six, 12 and 18-24 months after treatment started.

    The team from the University’s School of Psychological Science and the Psychosis Research Unit at Greater Manchester West Mental Health NHS Foundation Trust adds weight to earlier studies in this area.

    CBT is a person-centred approach which involves helping people understand how the way they make sense of their experiences, and how they respond to them, can often determine how distressing or disabling they are. Through CBT, patients learn a range of strategies they can use to reduce their distress, allowing them to work towards a recovery which is meaningful to them. CBT for psychosis prevention places a heavy emphasis on ‘normalising’ and de-stigmatising experiences such as hearing voices or having paranoid thoughts.

    The research team analysed previous studies which covered 800 people at high risk of developing psychosis. Patients were randomly allocated to receive either CBT or a control treatment, which was either treatment as usual or supportive counselling.

    Dr Paul Hutton, who led the study which has been published in Psychological Medicine, said: “We found that the risk of developing a full-blown psychotic illness was more than halved for those receiving CBT at six, 12 and 18-24 months after treatment started.

    “Our research suggests that young people seeking help who are at risk of developing psychosis should now be offered a package of care which includes at least six months of CBT.

    There was no evidence that CBT had adverse effects, although we argue future clinical trials should measure this more thoroughly. Our analysis also suggests that existing CBT approaches may need to be adapted to focus more on improving social and occupational functioning.”

    The Manchester findings back conclusions from a similar analysis conducted by researchers from the National Institute of Clinical Excellence and University of Manchester researcher Professor Tony Morrison which was reported in the British Medical Journal in January.

    The University of Manchester has played an important role in the development of CBT, with Professor Morrison, who also works part-time at Greater Manchester West Mental Health NHS Foundation Trust, and colleagues pioneering its use for psychosis prevention and conducting the first clinical trials in this area in 1999. Manchester Professor Alison Yung, formerly of University of Melbourne, was one of the first researchers to develop reliable tools for identifying those at incipient risk of psychosis.

    The University of Manchester works closely with The Early Detection and Intervention Team, based at Greater Manchester West Mental Health NHS Foundation Trust which has one of the few dedicated psychosis prevention clinics in the UK. The clinic allows young people at risk of psychosis regular assessments, sign-posting and access to CBT and case management.