Analysis of CBT Intervention for Psychosis and Comorbidities

This report provides a critical analysis of a randomized controlled trial, known as the GOALS study, investigating the effectiveness of a brief Cognitive Behavioral Therapy (CBT) intervention delivered by frontline mental health staff for individuals experiencing psychosis and comorbid anxiety or depression. The analysis covers the study's background, which highlights the need for improved access to therapeutic interventions and the rationale for training mental health staff to deliver CBT. The methods section details the recruitment and randomization process, the intervention protocol, and the outcome measures used to assess clinical feasibility and efficacy. The discussion section summarizes the study's findings, emphasizing the potential of the GOALS approach, and the ongoing efforts to finalize training curricula and treatment manuals. The report concludes by evaluating the study's strengths and limitations, and discussing the implications of the findings for clinical practice and future research. The report also includes a brief summary of the CASP checklist used to assess the qualitative research.

Critical analysis on 4
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Table of Contents
INTRODUCTION...........................................................................................................................3
MAIN BODY...................................................................................................................................3
Background.................................................................................................................................3
Methods.......................................................................................................................................4
Sample size..................................................................................................................................4
Discussion...................................................................................................................................4
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INTRODUCTION
The given article is based on CBT intervention which is to be delivered by healthcare
professionals of Frontline to the patients who are experiencing psychosis along with comorbiod
anxiety or depression. CBT refers to the cognitive behavioural therapy which is an effective
treatment for reducing distressing symptoms as well as hospitalizations in comparison to
medication alone. The main objective of the study is to support individuals with psychosis and
work towards a personal recovery goal. NICE guidelines states that CBT must be implemented
on all patients who are suffering from mental disorders like psychosis. Some of the new
behavioural approaches for schizophrenia has been created to focus particular on recovery
oriented outcomes.
MAIN BODY
Background
It is estimated that over half of the population in UK alone suffer from psychosis. Such
medical disorders prevent individuals from engaging in some meaningful activities and from
acquiring life gaols. Promoting recovery induce people to overcome from such obstacles and
help them to achieve desirable goals. However, some of the CBT approaches are available
which is adapted by UK government in order to reduce effects of depression and anxiety. Based
on evidenced based methods the study has developed a new intervention which is designed
which help individuals to achieve personal goals and enhance recovery that can be deliver by
mental care practitioners of Frontline. A small scale pre-piolet study has been conducted in order
to evaluate the effectiveness of intervention where six staff member deliver the intervention to 12
service users. All the participants showed clinical improvement and were able to acquire their
goals. There was a positive feedback of both staff members and service users for the
intervention. Aim of this study is to run a controlled trial for the intervention which is particular
designed for individuals with psychosis. GOALS study which is Getting On top
of Anxiety and Low mood was implemented on patients with psychosis.
Methods
The methods used in the study was recruitment and randomization, where sixty-six
participants were recruited with a diagnosis of psychosis along with symptoms of anxiety and
depression from mental health services. Those who refused medication were excluded. With the
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help of randomization method, participants were assigned to intervention group will receive a 8-
week intervention by trained staff member and was supervised by study coordinator. Outcomes
were assessed blind to the condition of treatment at 0, 12 and 18 weeks post-randomization.
Primary outcome measure include measure for efficacy analysis and secondary outcome measure
include psychotic symptoms, mood, quality of life and clinical distress. A health economic
analysis comparing with service use in each condition was performed. Recruitment initiate from
March 2013 and continued till December 2014.
Sample size
Inn order to determine sample size, a liberal power calculation for efficacy signal
detection was carried out and total number of participants in the study was 66.
Discussion
Anxiety and depression are commonly present in individuals. CBT is an effective therapy
for emotional problems for psychosis. The study has adapted CBT to address particular needs
and problems of individuals with psychosis. The advantage of GOALS approach is that it is brief
and care professionals of Frontline will be trained. Study also aims at finalising training
curriculum as well as treatment manual. Results will be available in August 2016 to know if this
intervention is clinically feasible.
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