Who does not get cognitive-behavioral therapy for schizophrenia when therapy is readily available?

The evidence base for using cognitive-behavioral therapy in schizophrenia is well established; it is recommended in guidelines by the Schizophrenia Patient Outcomes Research Team.

Data were examined regarding referral patterns for patients with schizophrenia who were seen by one of four psychiatrists at the mental health center providing services to West Southampton (England).

Of the 142 patients identified, 69 had and 73 had not been referred for cognitive-behavioral therapy. Patients tended not to be referred if they were considered to be doing well and not in need of therapy or were unlikely to engage.

In a location where cognitive-behavioral therapy for schizophrenia was readily available, half of all patients were considered appropriate for referral. Improved engagement skills and more assertive outreach by therapists and consideration by referrers of the benefits of relapse prevention might bring the benefits of cognitive-behavioral therapy to a still broader group.