FREEDOM OF INFORMATION ACT 2000 REQUEST
COGNITIVE BEHAVIOURAL THERAPY FOR PSYCHOSIS (CBTp)
INDIVIDUALISATION, OUTCOME MONITORING AND RESPONSE TO TREATMENT FAILURE
Please provide the following recorded information held by the Trust concerning psychological interventions provided to adults with psychosis or schizophrenia.
This request is concerned particularly with Cognitive Behavioural Therapy for psychosis (CBTp) but where the Trust’s relevant policies or governance arrangements apply more generally to psychological interventions for psychosis, please provide those documents.
The period for questions 2-4 below is 1 January 2022 to the date of this request.
1 Policies, Procedures and Clinical Guidance
Please provide the current version of any policy, procedure, clinical pathway, protocol, guidance, standard operating procedure or equivalent recorded document setting out:
a) how the individual patient’s goals, preferences, needs and treatment priorities are identified and
incorporated into the psychological intervention.
b) how the effectiveness or clinical benefit of the psychological intervention is assessed for the
individual patient.
c) which outcome measures, assessment tools or other measures are expected to be used before,
during and/or following treatment.
d) how service-user satisfaction, helpfulness, acceptability or experience of the intervention is
assessed or recorded.
e) how the intended course or “dose” of CBTp is determined and recorded, including the number of
sessions planned and how compliance with the relevant CBTp model or core components is
assured.
f) how non-initiation following referral or offer, disengagement, early discontinuation or non-completion
is assessed and recorded, including the reasons for this and whether the suitability, accessibility or
acceptability of the intervention is considered.
g) whether barriers to engagement or effective participation are expected to be assessed including,
where relevant, cognitive or communication difficulties, sleep disturbance, distress or arousal,
medication adverse effects, physical health problems or practical/social barriers.
h) what clinical review or action is expected where the intervention has not produced the intended
benefit, including whether the diagnosis, clinical formulation, treatment plan, barriers to participation
or treatment approach should be reconsidered.
I) how alternative or adapted psychological approaches are considered where CBTp is ineffective,
unsuitable or unacceptable to the patient or cannot be completed.
j) how psychological interventions are adapted where an individual has relevant neurodevelopmental,
cognitive or communication needs.
2 Audit, evaluation and quality assurance
Please provide copies of any audits, evaluations, quality-improvement reviews, assurance reports or
equivalent recorded assessments undertaken during the period specified above which examined any of the following:
* whether CBTp or other psychological interventions achieved intended clinical outcomes
* compliance with requirements to monitor outcomes routinely and systematically
* service-user satisfaction, helpfulness or acceptability
* referral, offer, commencement, completion or non-completion of psychological interventions
* reasons for non-initiation, disengagement, early discontinuation or non-completion
* the number of CBTp sessions planned compared with the number actually attended or delivered
* whether CBTp was planned and delivered in accordance with relevant NICE recommendations
including the recommended course of at least 16 planned individual CBT sessions
* adherence to the intended CBTp model or its required/core components
– 2 –
* individualisation or personalisation of psychological treatment
* barriers affecting engagement or participation
* action taken following inadequate response to psychological treatment.
3 Aggregate management and outcome information
Please provide any existing aggregate report, dashboard, dataset summary or other recorded management information held by the Trust showing, for CBTp for psychosis:
a) numbers or proportions referred for CBTp
b) numbers or proportions offered CBTp
c) numbers or proportions commencing CBTp including where held, the numbers attending at least one
session
d) numbers or proportions for whom a course of at least 16 sessions was planned
e) the number of sessions actually attended or delivered, where this is already held in aggregate form,
including any existing mean, median, range or equivalent summary
f) numbers or proportions completing the planned course or any locally defined adequate course
g) numbers or proportions not commencing, disengaging early or not completing treatment
h) recorded reasons or reason categories for non-initiation, disengagement or non-completion
I) recorded clinical outcome or outcome measure results
j) any aggregate service-user satisfaction.
4 Governance oversight
Please provide copies of any reports, papers, presentations, relevant minute sections or action plans presented during the period specified above to the Trust Board or a Trust-level governance, quality, clinical effectiveness, psychological therapies or equivalent committee concerning:
* effectiveness or clinical outcome of CBTp or other psychological interventions for psychosis
* access to, engagement with or completion of CBTp
* the difference between psychological treatment being offered and treatment actually being
commenced or received
* patient experience, satisfaction or acceptability
* treatment non-response, non-initiation, disengagement or non-completion
* deficiencies in outcome measurement or recording of treatment/dose sessions received
* compliance with relevant NICE recommendations concerning the delivery, monitoring and review of
psychological interventions for psychosis
* competence, training or supervision of staff delivering CBTp
* action taken to improve the effectiveness, individualisation, accessibility or monitoring of those
interventions.
Scope
This request does not seek:
* patient-identifiable information
* examination of individual clinical records
* creation of new statistics, calculations or analyses
* explanations, opinions or clinical judgements that are not already recorded.
Where one document answers more than one part of this request, please provide the document only once and identify the questions to which it relates.
Where a relevant document contains substantial material unrelated to this request, provision of the relevant section or extract is sufficient.
Where no recorded information is held for a particular part, please state that explicitly. Electronic copies by email would be appreciated.

