Perry Yael, Murrihy Rachael C, Varlow Megan, Dedousis-Wallace Anna, Ellis Danielle M, Langdon Robyn, Kidman Antony D
Health Psychology Unit, University of Technology Sydney, Sydney, New South Wales, Australia.
Early Interv Psychiatry. 2015 Jun;9(3):252-9. doi: 10.1111/eip.12145. Epub 2014 Apr 17.
Cognitive behaviour therapy (CBT) is a clinically indicated treatment for first-episode psychosis. Despite this, CBT for early psychosis is not routinely available as part of standard mental health services in Australia. The aim of this pilot project was to develop a CBT for early psychosis service to be provided as an adjunct to existing community mental health services. This study examined the feasibility of this service model, delivered in a real-world setting. A secondary aim was to explore the effectiveness of this service, as measured by clinical and functional outcomes.
Participants living in northern Sydney, Australia, and who had recently experienced a first episode of psychosis, were offered up to 20 sessions of individual CBT. Service feasibility was measured via attrition rates, therapy attendance and referrer feedback. Measures of psychosis, depression, anxiety and psychosocial functioning, were assessed pretreatment, after six and 12 sessions, and at 3 months post-treatment.
Nineteen clients attended treatment to completion. Survey feedback from referrers affirmed the positive impact of the service on clients' recovery. Additionally, clients showed improvements in symptoms of psychosis over the first three time points. Psychosocial functioning also shifted from the moderately to mildly impaired range by the end of treatment.
The CBT for early psychosis service has been successfully integrated into the mental health landscape of northern Sydney. Outcomes of this pilot project are discussed with reference to the achievements of the service, as well as the obstacles encountered, and how they were overcome.
认知行为疗法（CBT）是首次发作精神病的临床指定治疗方法。尽管如此，在澳大利亚，早期精神病的CBT并非标准心理健康服务的常规组成部分。这个试点项目的目的是开发一种早期精神病服务的CBT，作为现有社区心理健康服务的辅助手段。本研究考察了在现实环境中提供这种服务模式的可行性。第二个目的是通过临床和功能结果来探索这种服务的有效性。
居住在澳大利亚悉尼北部且最近经历首次精神病发作的参与者可接受多达20次的个体CBT治疗。通过流失率、治疗出勤率和转诊者反馈来衡量服务可行性。在治疗前、6次和12次治疗后以及治疗后3个月评估精神病、抑郁、焦虑和心理社会功能的指标。
19名客户完成了治疗。转诊者的调查反馈肯定了该服务对客户康复的积极影响。此外，在最初三个时间点，客户的精神病症状有所改善。到治疗结束时，心理社会功能也从中度受损范围转变为轻度受损范围。
早期精神病服务的CBT已成功融入悉尼北部的心理健康格局。本试点项目的结果将结合该服务的成就、遇到的障碍以及如何克服这些障碍进行讨论。
