CBT and recovery from psychosis in the ISREP trial: mediating effects of hope and positive beliefs on activity.

OBJECTIVE

Hope and positive self-concept have been highlighted as important components of recovery from psychosis. This study investigated the impact of a recovery-focused intervention on these dimensions, as well as their role as mediators of functional outcome.

METHODS

Seventy-seven participants in recovery from psychosis were recruited into a randomized controlled trial of social recovery-focused cognitive-behavioral therapy (SRCBT). The primary outcome was hours spent weekly in structured activity. Hopelessness and beliefs about self and others were also assessed.

RESULTS

SRCBT had a significant effect on improving positive beliefs about self and others. A trend was noted suggesting a main effect of SRCBT on reducing hopelessness among individuals with nonaffective psychosis. Increases in positive beliefs about self were found to mediate improvements in activity in the SRCBT group.

CONCLUSIONS

Fostering hope and positive self-concept should be central components of recovery-oriented services and interventions. Modifying these dimensions may have a positive impact on functional outcome.