Cognitive therapy for patients with schizophrenia

摘要

Anthony Morrison and colleagues1 provide an interesting perspective on the use of cognitive behavioural therapy (CBT) in patients with schizophrenia spectrum disorders through their pilot study. Although compliance to CBT was reportedly measured, the extent of the adherence to the theoretical construct in actual delivery was not reported in the paper.1 Although competence of staff providing CBT was deemed adequate, whether and to what degree the therapists used CBT principles during the sessions was not clear. Since this pilot study focused on feasibility, the measurement of such fidelity to psychotherapeutic construct would be important to ascribe the benefits of CBT to the therapeutic process. CBT for patients with schizophrenia spectrum disorders is quite difficult and requires modification of the usual techniques.2 Engagement is often considered difficult in such patients, so a retention rate of more than 80% by sixth session is quite encouraging. The mean number of sessions (13-3 sessions) suggests that most participants did not complete the planned 26 sessions. Other medication effectiveness studies like CATIE and CUtLASS34also reported similar substantial dropout rates.