Service user satisfaction with cognitive behavioural therapy for psychosis: Associations with therapy outcomes and perceptions of the therapist.

Journal article

Objectives

Few studies have investigated service-user satisfaction with cognitive behavioural therapy for psychosis (CBTp). This study explored its associations with clinical presentation and outcomes, retrospective expectations of progress, perceptions of the therapist and demographic variables.

Design and Methods

One-hundred and sixty-five service-users completed self-report questionnaires pre- and post-CBTp in relation to the constructs of interest. Regression analyses explored associations with (i) overall satisfaction with therapy (ii) perceived progress, skills and knowledge gained.

Results

Ninety-six percent of service users reported satisfaction with therapy. Higher levels of overall satisfaction with, and perceived benefit from, therapy were associated with positive therapy expectations, positive ratings of therapist’s personal qualities, competence and trustworthiness, lower pre-therapy depression and improvements in quality of life. Symptom improvements were not related to overall satisfaction with therapy; however, with the exception of voices, better clinical outcomes were associated with subjective ratings of having made more progress and gained more CBT skills and knowledge. Demographic factors were not associated with satisfaction or perceived progress. In multiple regression analyses, expectations of progress showed the strongest associations with both satisfaction and perceived benefits. Other remaining significant associations consisted of perceptions of the therapist for satisfaction, and both pretherapy levels of, and changes in, depression for perceived benefits. Qualitative feedback emphasised the importance of the therapeutic relationship and developing new coping strategies.

Conclusions

The findings provide preliminary evidence that high levels of satisfaction with therapy are not contingent on good clinical outcomes and are instead associated with positive therapy expectations and perceptions of the therapist.

Authors: Lawlor, C; Sharma, B; Khondoker, M; Peters, E; Kuipers, E

• Publication status: Published
• Peer review status: Peer reviewed
• Publisher: Wiley
• Journal: British Journal of Clinical Psychology
• Volume: 56
• Issue: 1
• Pages: 84-102
• Publication date: 2016-12-01
• Acceptance date: 2016-10-12
• DOI: 10.1111/bjc.12122
• EISSN: 2044-8260
• ISSN: 0144-6657
• Language: English
• Keywords: cognitive behavioural therapy; psychosis; service-user satisfaction; therapeutic relationship