CBT and recovery from psychosis in the ISREP Trial: Mediating effects of hope and positive beliefs on activity

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Joanne Hodgekins and David Fowler



Objective: Hope and positive self-concept have been highlighted as important components of recovery from psychosis. This study investigated the impact of a recovery-focused intervention on these dimensions, as well as their role as mediators of functional outcome.


Methods: Seventy-seven participants in recovery from psychosis were recruited into a randomized controlled trial of social recovery–focused cognitive-behavioural therapy (SRCBT). The primary outcome was hours spent weekly in structured activity. Hopelessness and beliefs about self and others were also assessed.


Results: SRCBT had a significant effect on improving positive beliefs about self and others. A trend was noted suggesting a main effect of SRCBT on reducing hopelessness among individuals with nonaffective psychosis. Increases in positive beliefs about self were found to mediate improvements in activity in the SRCBT group.


Conclusions: Fostering hope and positive self-concept should be central components of recovery-oriented services and interventions. Modifying these dimensions may have a positive impact on functional outcome.