Opening the Black Box of Cognitive-Behavioural Case Management in Ultra-High Risk for Psychosis Clients

Jessica A Hartmann; Patrick McGorry; Stefanie Schmidt; Paul Amminger; Hok Pan Yuen; Connie Markuley; Gregor E. Berger; Eric Y H Chen; Lieuwe de Haan; Ian B. Hickie; Suzie Lavoie; Meredith J McHugh; Nilufar Mossaheb; D. H. Nieman; Merete Nordentoft; Anita Riecher-Rössler; Miriam R. Schäfer; M. Schlögelhofer; S.  Smesny; Andrew Thompson; Swapna Kamal Verma; Alison Yung; Barnaby Nelson

doi:10.1159/000477551

Opening the Black Box of Cognitive-Behavioural Case Management in Ultra-High Risk for Psychosis Clients

Jessica A Hartmann, Patrick McGorry, Stefanie Schmidt, Paul Amminger, Hok Pan Yuen, Connie Markuley, Gregor E. Berger, Eric Y H Chen, Lieuwe de Haan, Ian B. Hickie, Suzie Lavoie, Meredith J McHugh, Nilufar Mossaheb, D. H. Nieman, Merete Nordentoft, Anita Riecher-Rössler, Miriam R. Schäfer, M. Schlögelhofer, S. Smesny, Andrew ThompsonSwapna Kamal Verma, Alison Yung, Barnaby Nelson

Division of Psychology & Mental Health (L5)

Research output: Contribution to journal › Article › peer-review

32 Downloads (Pure)

Abstract

Background: Cognitive Behavioural Therapy (CBT) is the first-choice treatment in the ultra-high risk (UHR) for psychosis group. However, CBT is an umbrella term for a plethora of different strategies, and little is known about the association between intensity and content of CBT and severity of symptomatic outcome.

Methods: A sample of 268 UHR participants received six months of cognitive behavioural therapy with case management (CBCM) in the context of the multi-centre Neurapro trial with monthly assessments of attenuated psychotic symptoms (APS). Using multilevel regressions and controlling for initial severity of APS, the association between (1) number of CBCM sessions received and severity of APS, and (2) specific CBCM components and severity of APS, were investigated.

Results: In Month 1, a higher number of sessions and more assessment of symptoms predicted an increase of APS, while in Month 3, a higher number of sessions and more monitoring predicted a decrease in level of APS. More therapeutic focus on APS predicted an increase of APS overall.

Conclusions: Our findings indicate that the association between intensity/content of CBCM and severity of APS in a sample of UHR participants depends on time in treatment. CBCM may positively impact severity of APS later in the course of treatment. Therefore, it would seem important to keep UHR young people engaged in treatment beyond this initial period. Regarding the specific content of CBCM, a therapeutic focus on APS may not necessarily be beneficial in reducing the severity of APS, a possibility in need of further investigation.

Original language	English
Journal	Psychotherapy and Psychosomatics
Early online date	14 Sept 2017
DOIs	https://doi.org/10.1159/000477551
Publication status	Published - 2017

Access to Document

10.1159/000477551

CBCM_AAMAccepted author manuscript, 109 KB

Cite this

Hartmann, J. A., McGorry, P., Schmidt, S., Amminger, P., Yuen, H. P., Markuley, C., Berger, G. E., Chen, E. Y. H., de Haan, L., Hickie, I. B., Lavoie, S., McHugh, M. J., Mossaheb, N., Nieman, D. H., Nordentoft, M., Riecher-Rössler, A., Schäfer, M. R., Schlögelhofer, M., Smesny, S., ... Nelson, B. (2017). Opening the Black Box of Cognitive-Behavioural Case Management in Ultra-High Risk for Psychosis Clients. Psychotherapy and Psychosomatics. https://doi.org/10.1159/000477551

@article{b87533de107e4f8a9d87226eb70e866b,

title = "Opening the Black Box of Cognitive-Behavioural Case Management in Ultra-High Risk for Psychosis Clients",

abstract = "Background: Cognitive Behavioural Therapy (CBT) is the first-choice treatment in the ultra-high risk (UHR) for psychosis group. However, CBT is an umbrella term for a plethora of different strategies, and little is known about the association between intensity and content of CBT and severity of symptomatic outcome. Methods: A sample of 268 UHR participants received six months of cognitive behavioural therapy with case management (CBCM) in the context of the multi-centre Neurapro trial with monthly assessments of attenuated psychotic symptoms (APS). Using multilevel regressions and controlling for initial severity of APS, the association between (1) number of CBCM sessions received and severity of APS, and (2) specific CBCM components and severity of APS, were investigated. Results: In Month 1, a higher number of sessions and more assessment of symptoms predicted an increase of APS, while in Month 3, a higher number of sessions and more monitoring predicted a decrease in level of APS. More therapeutic focus on APS predicted an increase of APS overall. Conclusions: Our findings indicate that the association between intensity/content of CBCM and severity of APS in a sample of UHR participants depends on time in treatment. CBCM may positively impact severity of APS later in the course of treatment. Therefore, it would seem important to keep UHR young people engaged in treatment beyond this initial period. Regarding the specific content of CBCM, a therapeutic focus on APS may not necessarily be beneficial in reducing the severity of APS, a possibility in need of further investigation. ",

author = "Hartmann, {Jessica A} and Patrick McGorry and Stefanie Schmidt and Paul Amminger and Yuen, {Hok Pan} and Connie Markuley and Berger, {Gregor E.} and Chen, {Eric Y H} and {de Haan}, Lieuwe and Hickie, {Ian B.} and Suzie Lavoie and McHugh, {Meredith J} and Nilufar Mossaheb and Nieman, {D. H.} and Merete Nordentoft and Anita Riecher-R{\"o}ssler and Sch{\"a}fer, {Miriam R.} and M. Schl{\"o}gelhofer and S. Smesny and Andrew Thompson and Verma, {Swapna Kamal} and Alison Yung and Barnaby Nelson",

year = "2017",

doi = "10.1159/000477551",

language = "English",

journal = "Psychotherapy and Psychosomatics",

issn = "0033-3190",

publisher = "S. Karger AG",

}

Hartmann, JA, McGorry, P, Schmidt, S, Amminger, P, Yuen, HP, Markuley, C, Berger, GE, Chen, EYH, de Haan, L, Hickie, IB, Lavoie, S, McHugh, MJ, Mossaheb, N, Nieman, DH, Nordentoft, M, Riecher-Rössler, A, Schäfer, MR, Schlögelhofer, M, Smesny, S, Thompson, A, Verma, SK, Yung, A & Nelson, B 2017, 'Opening the Black Box of Cognitive-Behavioural Case Management in Ultra-High Risk for Psychosis Clients', Psychotherapy and Psychosomatics. https://doi.org/10.1159/000477551

TY - JOUR

T1 - Opening the Black Box of Cognitive-Behavioural Case Management in Ultra-High Risk for Psychosis Clients

AU - Hartmann, Jessica A

AU - McGorry, Patrick

AU - Schmidt, Stefanie

AU - Amminger, Paul

AU - Yuen, Hok Pan

AU - Markuley, Connie

AU - Berger, Gregor E.

AU - Chen, Eric Y H

AU - de Haan, Lieuwe

AU - Hickie, Ian B.

AU - Lavoie, Suzie

AU - McHugh, Meredith J

AU - Mossaheb, Nilufar

AU - Nieman, D. H.

AU - Nordentoft, Merete

AU - Riecher-Rössler, Anita

AU - Schäfer, Miriam R.

AU - Schlögelhofer, M.

AU - Smesny, S.

AU - Thompson, Andrew

AU - Verma, Swapna Kamal

AU - Yung, Alison

AU - Nelson, Barnaby

PY - 2017

Y1 - 2017

N2 - Background: Cognitive Behavioural Therapy (CBT) is the first-choice treatment in the ultra-high risk (UHR) for psychosis group. However, CBT is an umbrella term for a plethora of different strategies, and little is known about the association between intensity and content of CBT and severity of symptomatic outcome. Methods: A sample of 268 UHR participants received six months of cognitive behavioural therapy with case management (CBCM) in the context of the multi-centre Neurapro trial with monthly assessments of attenuated psychotic symptoms (APS). Using multilevel regressions and controlling for initial severity of APS, the association between (1) number of CBCM sessions received and severity of APS, and (2) specific CBCM components and severity of APS, were investigated. Results: In Month 1, a higher number of sessions and more assessment of symptoms predicted an increase of APS, while in Month 3, a higher number of sessions and more monitoring predicted a decrease in level of APS. More therapeutic focus on APS predicted an increase of APS overall. Conclusions: Our findings indicate that the association between intensity/content of CBCM and severity of APS in a sample of UHR participants depends on time in treatment. CBCM may positively impact severity of APS later in the course of treatment. Therefore, it would seem important to keep UHR young people engaged in treatment beyond this initial period. Regarding the specific content of CBCM, a therapeutic focus on APS may not necessarily be beneficial in reducing the severity of APS, a possibility in need of further investigation.

AB - Background: Cognitive Behavioural Therapy (CBT) is the first-choice treatment in the ultra-high risk (UHR) for psychosis group. However, CBT is an umbrella term for a plethora of different strategies, and little is known about the association between intensity and content of CBT and severity of symptomatic outcome. Methods: A sample of 268 UHR participants received six months of cognitive behavioural therapy with case management (CBCM) in the context of the multi-centre Neurapro trial with monthly assessments of attenuated psychotic symptoms (APS). Using multilevel regressions and controlling for initial severity of APS, the association between (1) number of CBCM sessions received and severity of APS, and (2) specific CBCM components and severity of APS, were investigated. Results: In Month 1, a higher number of sessions and more assessment of symptoms predicted an increase of APS, while in Month 3, a higher number of sessions and more monitoring predicted a decrease in level of APS. More therapeutic focus on APS predicted an increase of APS overall. Conclusions: Our findings indicate that the association between intensity/content of CBCM and severity of APS in a sample of UHR participants depends on time in treatment. CBCM may positively impact severity of APS later in the course of treatment. Therefore, it would seem important to keep UHR young people engaged in treatment beyond this initial period. Regarding the specific content of CBCM, a therapeutic focus on APS may not necessarily be beneficial in reducing the severity of APS, a possibility in need of further investigation.

U2 - 10.1159/000477551

DO - 10.1159/000477551

M3 - Article

SN - 0033-3190

JO - Psychotherapy and Psychosomatics

JF - Psychotherapy and Psychosomatics

ER -

Opening the Black Box of Cognitive-Behavioural Case Management in Ultra-High Risk for Psychosis Clients

Abstract

Access to Document

Fingerprint

Cite this