A community-based investigation into the social functioning and quality of life outcomes for individuals receiving a trial of cognitive behavioural therapy for treatment-resistant psychotic symptoms.
Creators: name: Moller, Bridget
Publisher: name: RMIT University
Year: 2024

description: Psychotic disorders are characterised by episodes consisting of delusions, hallucinations, and disordered thinking and behaviour. As researchers have been able to identify the cognitive components contributing to psychotic symptoms, they have explored the efficacy of Cognitive-Behavioural Therapy (CBT) for individuals in different stages of the illness. This previous body of research has demonstrated the positive results of different trials of CBT, over a number of locations, and with different populations. However, CBT for psychosis continues to be a relatively new and unexplored treatment area, particularly in relation to defining and examining social functioning and quality of life outcomes, and exploring caregivers’ views on these areas. Therefore, the current study aimed to explore the results of a trial of CBT for individuals experiencing ongoing psychotic symptoms despite receiving routine care and treatments. Psychotic symptoms, quality of life, and social functioning were examined using clinician-rated tools, questionnaires completed by participants and their caregivers, as well as information given in post-treatment interviews with participants and caregivers. It was predicted that there would be a significant decrease in psychotic symptoms over the course of the treatment. <br><br>Furthermore, it was predicted that there would be significant increases in social functioning and quality of life over the course of the treatment. The quantitative and qualitative data provided mixed results. Statistical analyses suggested that participants experienced significant decreases in their delusions from pre-treatment to post-treatment. These decreases were most apparent in participants’ pre-occupation with their delusions, distress associated with the delusions, and their conviction in their delusional beliefs. Participants rated themselves higher in interpersonal communication skills than caregivers rated participants. Changes in pro-social activities approached significance from baseline to post-treatment, although an examination of the data suggested that the greatest change occurred from baseline to pre-treatment. There were no statistically significant results for other social functioning areas or quality of life. Implementing clinical significance criteria, results indicated that few participants experienced decreases in psychotic symptoms, and increases in their quality of life and social functioning as rated by themselves and their caregivers. These criteria also indicated that there was clinically significant worsening in participants’ social functioning and quality of life. Graphical representations of participants’ data from each assessment period, and at each session, suggested that several participants experienced reductions in their psychotic symptoms over the course of the therapy. <br><br>Finally, a grounded theory methodology was implemented to examine information provided by participants and their caregivers regarding their experiences of the therapy, and any changes noticed in symptoms and functioning over time. The categories and sub-categories that emerged from this data indicated that participants and their caregivers noticed changes in the participants’ thoughts, feelings, and behaviours over the course of the treatment program. Additionally, changes were noticed in participants’ attitudes and self-esteem, social relationships, hygiene and self-care, activities and independence. Participants and their caregivers attributed these changes to several factors, including medication adherence, CBT, the mental health service, reduced substance use, the opportunity to talk, occupying activities, and motivation and coping strategies.