‘That hour served me better than any hour I have ever had before’: Service users’ experiences of CBTp in first episode psychosis

Abstract

Despite an emerging number of studies investigating service users’ experiences of receiving cognitive behavioural therapy for psychosis (CBTp), no studies to date have focused on individuals with first episode psychosis (FEP). Available research in FEP indicates that young people may delay seeking professional help due to having negative expectations of therapy and upholding unhelpful attitudes toward such treatment, which delays uptake to early intervention in psychosis (EIP) services in the NHS. The present study attempts to address the apparent gap in existing knowledge and explores expectations and experiences of receiving CBTp among EIP clients with FEP.Semi-structured qualitative interviews were conducted with nine participants with FEP who had received CBTp in a London-based EIP. Researchers had the flexibility to focus on the identified areas of service user experience and explored their reflections on the received therapy. Questions related to prior expectations and the actual experience of participating in such therapeutic treatment.Interviews were analysed using thematic analysis. Four major themes emerged, including: service user’s prior expectations; therapeutic alliance; challenges of CBTp; and application of CBTp to achieve change.Although some negative assumptions preceded the commencement of therapy, optimistic expectations were also voiced. Overall, participants reported largely positive experiences of receiving CBTp in relation to both the process of treatment and qualities demonstrated by their therapists, despite experiencing some challenges related to achieving change. Central importance of functional therapeutic alliance in CBTp was indicated, based on which major therapeutic gains were achieved, even in spite of, at times, pre-existing worrisome expectations.