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Cognitively-oriented psychotherapy for early psychosis (COPE): Preliminary results

Published online by Cambridge University Press:  06 August 2018

H. Jackson ,
P. McGorry ,
J. Edwards ,
C. Hulbert ,
L. Henry ,
S. Francey ,
D. Maude ,
J. Cocks ,
P. Power  and
S. Harrigan
...Show all authors
H. Jackson*
Affiliation:
University of Melbourne, Victoria
P. McGorry
Affiliation:
Department of Psychiatry, University of Melbourne, and Early Psychosis Prevention and Intervention Centre (EPPIC), Centre for Young People's Mental Health, Victoria
J. Edwards
Affiliation:
Centre for Young People's Mental Health, Victoria
C. Hulbert
Affiliation:
Preston and Northcote Community Hospital, Victoria
L. Henry
Affiliation:
Early Psychosis Research Centre, Centre for Young People's Mental Health, Victoria
S. Francey
Affiliation:
Centre for Young People's Mental Health, Victoria
D. Maude
Affiliation:
Centre for Young People's Mental Health, Victoria
J. Cocks
Affiliation:
Centre for Young People's Mental Health, Victoria
P. Power
Affiliation:
Centre for Young People's Mental Health, Victoria
S. Harrigan
Affiliation:
Centre for Young People's Mental Health, Victoria
P. Dudgeon
Affiliation:
Centre for Young People's Mental Health, Victoria
*
Correspondence: Professor H. Jackson, Department of Psychology, School of Behavioural Science, University of Melbourne, Parkville, 3052, Victoria, Australia. Fax: 0011 61 03 9347 6618; e-mail: [email protected]
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Abstract

Background The present study describes the results of the pilottesting of a therapy we have developed for people with first-episode psychosis. Cognitively-oriented psychotherapy for early psychosis (COPE) is aimed at facilitating the adjustment of the person, and at preventing or alleviating secondary morbidity in the wake of the first psychotic episode.

Method Eighty people formed three groups: those who were offered and accepted COPE (COPE subjects); those who refused COPE (refusal subjects); and those who were offered neither COPE nor any other continuing treatment from our service (control subjects). The individuals were assessed prior to, and at the end of, COPE treatment (a 12-month period) on the Integration/Sealing Over, Explanatory Model, Scale for the Assessment of Negative Symptoms, Brief Psychiatric Rating Scale, Quality of Life, SCL–90–R, and Beck Depression Inventory measures.

Results People who received COPE obtained significantly superior scores (P < 0.05) to the control group on four of the seven measures but only significantly out-performed the refusal group on one of the seven measures (P<0.05). The COPE group performed significantly worse on the BDI than the refusal group (P < 0.05). Effect sizes are also provided for each measure.

Conclusions There seems to be a place for psychological therapy in this group of people butour results need to be replicated in a more definitive randomised controlled trial and such a study is now in progress.

Type
Research Article
Information
The British Journal of Psychiatry , Volume 172 , Issue S33: Verging on reality , June 1998 , pp. 93 - 100
Copyright
Copyright © 1998 The Royal College of Psychiatrists 

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References

Amador, X. F., Strauss, D. H., Yale, S. A., et al (1991) Awareness of illness. Schizophrenia Bulletin, 17, 113–132.CrossRefGoogle ScholarPubMed
American Psychiatric Association (1987) Diagnostic and Statistical Manual of Mental Disorders (3rd edn, revised) (DSM–III–R). Washington, DC: APA.Google Scholar
Andreasen, N. C. (1983) Schedule for the Assessment of Negative Symptoms. Iowa City, IO: University of Iowa.Google Scholar
Andreasen, N. C. (1984) The Broken Brain: The Biological Revolution in Psychiatry. New York: Harper and Row.Google Scholar
Azar, B. (1997) APA Task Force urges a harder look at data. APA Monitor, 28, 26.Google Scholar
Bandura, A. (1977) Self-efficacy: Toward a unifying theory of behavioral change. Psychological Review, 84, 191–215.CrossRefGoogle Scholar
Bandura, A. (1986) Social Foundations of Thought and Action: A Social Cognitive Theory. Englewood Cliffs, NJ: Prentice-Hall.Google Scholar
Beck, A.T. & Beck, R.W. (1972) Screening depressed patients in family practice: A rapid technique. Postgraduate Medicine, 52, 81–85.Google Scholar
Beck, A.T., Rush, A. J., Shaw, B. F., et al (1979) Cognitive Therapy of Depression. New York: Guilford Press.Google Scholar
Beck, A.T. & Emery, G. (1985) Anxiety Disorders and Phobias: A Cognitive Perspective. New York: Basic Books.Google Scholar
Beck, A.T., Freeman, A. & Associates (1990) Cognitive Therapy of Personality Disorders. New York: Guilford Press.Google Scholar
Bellack, A. S. & Hersen, M. (eds) (1979) Research and Practice in Social Skills Training. New York: Plenum Press.CrossRefGoogle Scholar
Bentall, R. P. (1990) The syndromes and symptoms of psychosis. Or why you can't play ‘twenty questions’ with the concept of schizophrenia and hope to win. Reconstructing Schizophrenia (ed. Bentall, R. P.), pp. 23–60. London: Routledge.Google Scholar
Bentall, R. P., Haddock, G. & Slade, P. D. (1994) Cognitive behavior therapy for persistent auditory hallucinations: From theory to therapy. Behavior Therapy, 25, 51–66.Google Scholar
Birchwood, M. & Macmillan, F. (1993) Early intervention in schizophrenia. Australian and New Zealand journal of Psychiatry, 27, 374–378.Google Scholar
Birchwood, M., McGorry, P. & Jackson, H. (1997) Early intervention in schizophrenia. British Journal of Psychiatry, 170, 2–5 Google Scholar
Campbell, D.T. & Stanley, J. C. (1963) Experimental and Quasi-Experimental Designs for Research. Chicago, IL: Rand McNally.Google Scholar
Chadwick, P. & Birchwood, M. (1994) The omnipotence of voices. A cognitive approach to auditory hallucinations. British Journal of Psychiatry, 164, 190–201.Google Scholar
Clarke, G. N. (1995) Improving the transition from basic efficacy research to effectiveness studies: Methodological issues and procedures. Journal of Consulting and Clinical Psychology, 63, 718–725.Google Scholar
Cohen, J. (1992) A power primer. Psychological Bulletin, 112, 155–159.Google Scholar
Coursey, R. D. (1989) Psychotherapy with persons suffering from schizophrenia. Schizophrenia Bulletin, 15, 349–353.Google Scholar
Coursey, R. D., Keller, A. B. & Farrell, E. W. (1995) Individual psychotherapy and persons with serious mental illness: The clients’ perspective. Schizophrenia Bulletin, 21, 283–301.Google Scholar
Davidson, L. & Strauss, J. S. (1992) Sense of self in recovery from severe mental illness. British Journal of Medical Psychology, 65, 131–145.Google Scholar
Derogatis, L. R. (1977) SCL–90–R: Administration, Scoring and Procedures Manual. Towson, MD: Clinical Psychometric Research.Google Scholar
Derogatis, L. R. (1983) SCL–90–R: Administration, Scoring and Procedures Manual–II for the Revised Version. Towson, MD: Clinical Psychometric Research.Google Scholar
Dixon, L. B. & Lehman, A. F. (1995) Family interventions for schizophrenia. Schizophrenia Bulletin, 21, 631–643.Google Scholar
Drury, V., Birchwood, M., Cochrane, R., et al (1996) Cognitive therapy and recovery from acute psychosis: A controlled trial I: Impact on psychotic symptoms. British Journal of Psychiatry, 169, 593–607.Google Scholar
Edwards, J., Francey, S. M., McGorry, P. D., et al (1994) Early psychosis intervention: Evolution of a specialised community-based service. Behaviour Change, 12, 223–233.Google Scholar
Falloon, I. R. H. (1985) Family Management of Schizophrenia: A Study of the Clinical, Social, Family and Economic Benefits. Baltimore, MD: Johns Hopkins University Press.Google Scholar
Fowler, D. & Morley, S. (1989) The cognitive-behavioural treatment of hallucinations and delusions: A preliminary study. Behavioural Psychotherapy, 17, 267–282.Google Scholar
Fowler, D., Garety, P. & Kuipers, E. (1995) Cognitive Behaviour Therapy for Psychosis: Theory and Practice. Chichester: Wiley.Google Scholar
Guidano, V. F. (1987) Complexity of the Self New York: Guilford Press.Google Scholar
Gunderson, J. G., Frank, A. F., Katz, H. M., et al (1984) Effects of psychotherapy in schizophrenia. II. Comparative outcome of two forms of treatment. Schizophrenia Bulletin, 10, 564–598.CrossRefGoogle ScholarPubMed
Halford, W. K. & Hayes, R. (1991) Psychological rehabilitation of chronic schizophrenia patients: Recent findings on social skills training and family psychoeducation. Clinical Psychology Review, II, 23–44.CrossRefGoogle Scholar
Healy, D. (1990) The Suspended Revolution: Psychiatry and Psychotherapy Re-examined. London: Faber and Faber.Google Scholar
Healy, D. (1993) Images of Trauma: From Hysteria to Post-Traumatic Stress Disorder. London: Faber and Faber.Google Scholar
Heinrichs, D.W., Hanlon, T. E. & Carpenter, W. T. Jr (1984) The Quality of Life Scale: An instrument for rating the schizophrenic deficit syndrome. Schizophrenia Bulletin, 10, 389–398.Google Scholar
Hogarty, G. E., Anderson, C. M., Reiss, D. J., et al (1991) Family psychoeducation, social skills training, and maintenance chemotherapy in the after-care treatment of schizophrenia: II. Two-year effects of a controlled study on relapse and adjustment. Archives of General Psychiatry, 48, 340–347.Google Scholar
Hogarty, G. E., Kornblith, S. J., Greenwald, D., et al (1995) Personal therapy: A disorder-relevant psychotherapy for schizophrenia. Schizophrenia Bulletin, 21, 379–393.Google Scholar
Jackson, H. J., McGorry, P. D., Edwards, J., et al (1996) Cognitively oriented psychotherapy for early psychosis (COPE). In Early Intervention and Prevention in Mental Health (eds Cotton, P. & Jackson, H.), pp. 131–154. Melbourne: Australian Psychological Society.Google Scholar
Kazdin, A. E. (1980) Single-Case Research Designs: Methods for Clinical and Applied Settings. New York: Oxford University Press.Google Scholar
Kelly, G. (1955) The Psychology of Personal Constructs. New York: Norton.Google Scholar
Kingdon, D. G. & Turkington, D. (1994) Cognitive-Behavioral Therapy of Schizophrenia. New York: Guilford Press.Google Scholar
Kingdon, D. G., Turkington, D. & John, C. (1994) Cognitive behaviour therapy of schizophrenia: The amenability of delusions and hallucinations to reasoning. British Journal of Psychiatry 164, 581–587.CrossRefGoogle ScholarPubMed
Kleinman, A. (1980) Patients and Healers in the Context of Culture. An Exploration of the Borderline Between Anthropology, Medicine, and Psychiatry. Berkeley, CA: University of California Press, Ltd.Google Scholar
Mahoney, M.J. (1991) Human Change Processes: The Scientific Foundations of Psychotherapy. New York: Guilford Press.Google Scholar
May, P. R. A. (1968) Treatment of Schizophrenia: A Comparative Study of Five Treatment Methods. New York: Science House.Google Scholar
McGlashan, T. H., Wadeson, H. S., Carpenter, W.T., et al (1977) Art and recovery style from psychosis. Journal of Nervous and Mental Disease, 164, 182–190.Google Scholar
McGorry, P. D. (1992) The concept of recovery and secondary prevention in psychotic disorders. Australian and New Zealand Journal of Psychiatry, 26, 3–17.CrossRefGoogle ScholarPubMed
McGorry, P. D. (1994) The influence of illness duration on syndrome clarity and stability in functional psychosis: Does the diagnosis emerge and stabilise with time? Australian and New Zealand Journal of Psychiatry, 28, 607–619.Google Scholar
McGorry, P. D. (1995) Psychoeducation in first-episode psychosis: A therapeutic process. Psychiatry, 58, 329–344.Google Scholar
McGorry, P. D., Copolov, D. L. & Singh, B. S. (1990a) Royal Park Multidiagnostic Instrument for Psychosis: Rationale and review. Schizophrenia Bulletin, 16, 501–515.Google Scholar
McGorry, P. D., Copolov, D. L., Singh, B. S., et al (1990b) Royal Park Multidiagnostic Instrument for Psychosis: Development, reliability and validity. Schizophrenia Bulletin, 16, 517–536.Google Scholar
McGorry, P. D., Edwards, J., Mihalopoulis, C., et al (1996) EPPIC: An evolving system of early detection and optimal management. Schizophrenia Bulletin, 22, 305–326.Google Scholar
McGorry, P. D., Goodwin, R. J. & Stuart, G. W. (1988) The development, use, and reliability of the BPRS (Nursing Modification): An assessment procedure for the nursing team in clinical and research settings. Comprehensive Psychiatry, 29, 575–587.Google Scholar
Neimeyer, R. A. & Mahoney, M. J. (eds) (1995) Constructivism in Psychotherapy. Washington, DC: APA.Google Scholar
Overall, J. E. & Gorham, D. R. (1962) The Brief Psychiatric Rating Scale. Psychological Reports, 10, 799–812.Google Scholar
Perris, C. (1989) Cognitive Therapy with Schizophrenic Patients. New York: Guilford Press.Google Scholar
Robins, E. & Guze, S. B. (1970) Establishment of diagnostic validity in psychiatric illness: Its application to schizophrenia. American Journal of Psychiatry, 126, 983–987.Google Scholar
Rosenthal, R. (1991) Meta-Analytic Procedures for Social Research (revised edn). Newbury Park: Sage.Google Scholar
Sass, L. A. (1992) Madness and Modernism: Insanity in the Light of Modern Art, Literature, and Thought. New York: Basic Books.Google Scholar
Sass, L. A. (1994) The Paradoxes of Delusion: Wittgenstein, Schreber, and the Schizophrenic Mind. New York: Cornell University Press.Google Scholar
Scott, J. E. & Dixon, L. B. (1995) Psychological interventions for schizophrenia. Schizophrenia Bulletin, 21, 621–630.Google Scholar
Seligman, M. E. P. (1995) The effectiveness of psychotherapy: The Consumer Reports study. American Psychologist, 50, 965–974.Google Scholar
Sharp, H. M., Fear, C. F., Williams, J. M. G., et al (1996) Delusional phenomenology – Dimensions of change. Behaviour Research and Therapy, 34, 123–142.Google Scholar
Tarrier, N. (1992) Management and modification of residual positive psychotic symptoms. In Innovations in the Psychological Management of Schizophrenia: Assessment, Treatment and Services (eds Birchwood, M.J. & Tarrier, N.), pp. 147–169. Chichester: Wiley.Google Scholar
Tarrier, N., Beckett, R., Harwood, S., et al (1993) A trial of two cognitive-behavioural methods of treating drug-resistant residual psychotic symptoms in schizophrenic patients. British Journal of Psychiatry, 162, 524–532.Google Scholar
Weisz, J. R., Donenberg, G. R., Han, S. S., et al (1995) Bridging the gap between laboratory and clinic in child and adolescent psychotherapy. Journal of Consulting and Clinical Psychology, 63, 688–701.Google Scholar
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