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Reconsider widening access to CBT for schizophrenia, say researchers

Plans to widen access to cognitive behavioural therapy for patients with schizophrenia should be ‘reconsidered’, say researchers

They have urged the Government to reconsider current policy promoting CBT for schizophrenia, after their meta-analysis of 52 randomised controlled trials of CBT in schizophrenia conducted over the past 20 years showed little benefit.

The study, published in the British Journal of Psychiatry this month, revealed that CBT resulted in small therapeutic improvements in both positive and negative symptoms.

However, these benefits disappeared when the team analysed only trials where the assessments were masked, ie, where the assessor was not allowed to know which intervention – CBT or control – was used.

The researchers said their results cast further doubt on the effectiveness of CBT designed for schizophrenia, and questioned why the Government is continuing to encourage its use. The expansion of CBT for use in patients with psychosis is currently being encouraged throught the Improving Access to Psychological Therapies programme.

The team concluded: ‘Our finding of non-significant effects on positive symptoms of the disorder in a relatively large set of 21 masked studies also suggests that claims that CBT is effective against these symptoms are no longer tenable.

‘The same appears to apply to negative symptoms, although here the possibility that specially adapted forms of therapy will have an effect cannot be excluded.’

Study author Professor Keith Laws, professor of cognitive neuropsychology at the University of Hertfordshire, said: ‘With this evidence, the current Government policy which mandates this treatment for all patients with schizophrenia in England and Wales needs to be reconsidered.’


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