Understanding process in group cognitive behaviour therapy for psychosis

Area of Science:

• Psychology
• Psychiatry
• Clinical Psychology

Background:

• Group cognitive behaviour therapy for psychosis (GCBTp) is effective for symptom reduction and enhancing psychosocial aspects like self-esteem.
• The specific mechanisms driving these therapeutic improvements in GCBTp remain underexplored, particularly concerning interpersonal dynamics.

Purpose of the Study:

• To investigate the processes underlying therapeutic improvements in GCBTp, with a specific focus on interpersonal relationship factors.
• To identify how therapist alliance and group cohesion contribute to positive outcomes in early psychosis treatment.

Main Methods:

• A cohort of 66 individuals with early psychosis received 24 sessions of GCBTp over 3 months.
• Therapist alliance and group cohesion were assessed at three intervals, alongside session-by-session self-perceptions of symptoms and optimism.
• Participants were evaluated at baseline, post-treatment, and 6-month follow-up (9 months from baseline).

Main Results:

• Improvements in psychosis symptoms (BPRS), self-esteem (SERS-SF), and perceived therapeutic gains (CHOICE) were correlated with specific facets of therapist alliance and group cohesion.
• Optimism also played a significant role in these improvements.
• The relevance of these variables was not solely based on overall scores, highlighting the importance of specific moments during therapy.

Conclusions:

• Therapist alliance and group cohesion are significant predictors of therapeutic improvements in GCBTp, both immediately post-therapy and at follow-up.
• Stable therapeutic relationships and positive self-perceptions, particularly during challenging therapeutic work, are crucial for maximizing GCBTp effectiveness in early psychosis.