Group cognitive behavioural therapy for Chinese patients with psychotic disorder: A feasibility controlled study

Evidence for the effectiveness of individual cognitive behavioural therapy for psychosis (CBTp) is promising but evidence for presenting CBTp in a group setting and in the Asian context is limited. The present study is to evaluate the feasibility and effectiveness of Group CBTp in clinical practice.

Forty-eight out-patients and day-patients with the schizophrenia spectrum disorders were recruited and randomly assigned to the group CBTp plus treatment as usual (TAU), or psychoeducation group (PsyEdI) plus TAU. Both interventions consisted of 7 consecutive weekly sessions with a booster session 4 weeks after the last session. Patients were assessed on outcome measures such as the Psychotic Symptom Rating Scales (PSYRATS), the Beck Depression Inventory (BDI), a Chinese version of the Beliefs About Voice Questionnaire-Revised version (BAVQ-R), at baseline and after treatment.

Patients received group CBTp (n = 25) showed significantly greater improvement in their delusion compared with those receiving PsyEdI (n = 23). Nearly 61% of patients in the group CBTp showed at least 50% reduction on their score of delusion in the PSYRATS. Group CBTp was also found to be effective in reducing patients' dysfunctional beliefs towards voices, especially in the subscale of benevolence and omnipotence, their conviction on delusion, as well as their distress from positive psychotic symptoms.

Group CBTp can be an effective adjunctive psychological intervention in improving positive psychotic experiences among people with persistent psychotic symptoms, and can be applied in routine clinical practice.