Background: Increasing access to evidence-based talking therapies for people with psychosis is a national health priority. We have piloted a new, “low intensity” (LI) CBT intervention specifically designed to be delivered by frontline mental health staff, following brief training, and with ongoing supervision and support. A pilot feasibility study has demonstrated significant improvement in service user outcomes. This study is a qualitative analysis of the experiences of the staff and service users taking part in the evaluation. Aims: To evaluate the acceptability of the training protocol and the therapy, and to examine the factors promoting and restraining implementation. Method: All trained staff and service users completed a semi-structured interview that was transcribed and subjected to thematic analysis. Results: Service users spoke about learning new skills and achieving their goals. Staff spoke about being able to use a brief, structured intervention to achieve positive outcomes for their clients. Both groups felt that longer, more sophisticated interventions were required to address more complex problems. The positive clinical outcomes motivated therapists to continue using the approach, despite organizational barriers. Conclusions: For both trained staff and service users, taking part in the study was a positive experience. Staff members’ perceived skill development and positive reaction to seeing their clients improve should help to promote implementation. Work is needed to clarify whether and how more complex difficulties should be addressed by frontline staff.

Service user satisfaction with Cognitive Behavioural Therapy (CBT) for psychosis was examined with the Satisfaction with Therapy Questionnaire (STQ; Beck, Wright, Newman and Liese, 1993). Sixty-five service-users completed the STQ at the end of therapy, and 40 3-month post therapy. Overall, the majority of service-users were satisfied with therapy. Satisfaction was unaffected by service-user demographics or service issues, and remained stable over the 3-month follow-up. Belief in the extent to which CBT skills/knowledge had been gained predicted overall satisfaction at the end of therapy, while there was a near-significant effect for belief about the usefulness of homework(s) to predict overall satisfaction at 3-month follow-up. These results suggest that (i) CBT for psychosis is an acceptable intervention to service-users, regardless of their demographic characteristics or service issues; (ii) the specific aspects of CBT, not the non-specific attributes of therapy, predict overall satisfaction; (iii) homework setting may be important in ensuring ongoing satisfaction post-therapy.