Effectiveness and Mechanisms of Recovery Oriented Cognitive Therapy

Age: 18+

Sex: Any

Trial Phase: Academic

Sponsor: University of Pennsylvania

Must be taking: Antipsychotics

Disqualifiers: Brain damage, Suicidal risk, others

Stay on Your Current Meds You can continue your current medications while participating

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Compensation: Varies

Number of Visits: Unknown

Duration: 9 months

Trial Summary

Do I need to stop my current medications to join the trial?

No, you do not need to stop your current medications. The study involves adding cognitive therapy to your existing treatment.

What data supports the effectiveness of the treatment Recovery Oriented Cognitive Therapy (CT-R)?

Research shows that Recovery Oriented Cognitive Therapy (CT-R) can be effective for people with schizophrenia, as a study found positive outcomes six months after treatment. Additionally, cognitive therapy, which is similar to CT-R, has been shown to help with depression, suggesting that CT-R might also be beneficial for other mental health conditions. ^{1 2 3 4 5}

Is Recovery Oriented Cognitive Therapy (CT-R) safe for humans?

Recovery Oriented Cognitive Therapy (CT-R) has been studied in individuals with schizophrenia, and no specific safety concerns have been reported in the available research. ^{1 2 6 7 8}

How is this treatment different from other treatments for this condition?

This treatment is unique because it uses cognitive therapy (CT), which is a psychological approach that focuses on changing negative thought patterns. Unlike medications, CT aims to address the underlying thought processes contributing to the condition, making it a non-drug option that can be tailored to specific disorders. ^{1 2 6 9 10}

What is the purpose of this trial?

This trial is testing a type of talk therapy called CT-R for people with schizophrenia or schizoaffective disorder who are already on medication. CT-R helps patients focus on their personal goals and activities they enjoy to improve their thoughts and feelings about themselves. The study aims to see if this therapy can help improve their overall mental health and quality of life. Recovery-oriented cognitive therapy (CT-R) combines the principles of the recovery movement with cognitive therapy techniques, aimed at helping individuals with schizophrenia improve their motivation and information processing tasks.

Eligibility Criteria

Inclusion Criteria

Therapists: 25 years of age or above, licensed therapist, preliminarily trained in CT-R.

Timeline

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Training

Therapists complete a training phase consisting of a workshop and approximately 3 months of group supervision while providing CT-R to 1 training case each

3 months

Treatment

Participants receive Recovery Oriented Cognitive Therapy (CT-R) in weekly sessions for approximately 9 months

9 months

Follow-up

Participants are monitored for safety and effectiveness after treatment

6 months

Treatment Details

Interventions

• Recovery Oriented Cognitive Therapy (CT-R)

Participant Groups

Group I: Recovery Oriented Cognitive Therapy (CT-R) Experimental Treatment 1 Intervention

Therapists implement CT-R in weekly sessions for approximately 9 months while supported by a clinical supervisor. Therapists will have completed a supervised CT-R training case prior to the initiation of the randomized controlled trial. CT-R will focus on strengthening aspirations and focusing on activities that can bring about one's desired life. The therapist will use techniques to engage the patient in the adaptive mode, which involves activating cognitions, affects, motivation, and behaviors by engaging the individual in personally meaningful activities.

Group II: Continued Usual Care Active Control 1 Intervention

Who Is Running the Clinical Trial?

University of Pennsylvania

Lead Sponsor

Trials

2,118

Recruited

45,270,000+

Findings from Research

Cognitive therapy (CT) has evolved into a broad scientific approach that includes various disorder-specific interventions, making it adaptable for different psychological disorders.

The article reviews the efficacy and validity of CT, highlighting its effectiveness in treating conditions like posttraumatic stress disorder and health anxiety, while also noting the differences and similarities in treatment approaches for these disorders.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

The science of cognitive therapy. Hofmann, SG., Asmundson, GJ., Beck, AT.[2018]

Cognitive therapy (CT) is significantly more effective than waiting-list controls and antidepressants for treating mild to moderate depression, based on a meta-analysis of 48 high-quality trials involving 2765 patients.

CT may also help prevent relapses in the long term, suggesting it could be a more sustainable treatment option compared to antidepressants, which have higher relapse rates in naturalistic settings.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

A meta-analysis of the effects of cognitive therapy in depressed patients. Gloaguen, V., Cottraux, J., Cucherat, M., et al.[2022]

In a study of 420 veterans with PTSD, those receiving Seeking Safety (SS) had a higher treatment completion rate (89%) compared to those receiving cognitive processing therapy (CPT) (50%), indicating SS may be more acceptable for veterans.

However, veterans who completed CPT showed significantly greater reductions in PTSD symptoms, as measured by the PTSD checklist, suggesting that while SS is easier to complete, CPT may be more effective in reducing symptoms.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

A Comparison of Cognitive Processing Therapy and Seeking Safety for the Treatment of Posttraumatic Stress Disorder in Veterans. Baig, MR., Ouyang, S., Mata-Galán, E., et al.[2021]

References

1. United States pubmed.ncbi.nlm.nih.gov

Six-Month Follow-Up of Recovery-Oriented Cognitive Therapy for Low-Functioning Individuals With Schizophrenia. [2019]

2. United States pubmed.ncbi.nlm.nih.gov

Estimating outcome probabilities from early symptom changes in cognitive therapy for recurrent depression. [2023]

3. England pubmed.ncbi.nlm.nih.gov

Defined symptom-change trajectories during acute-phase cognitive therapy for depression predict better longitudinal outcomes. [2018]

4. United States pubmed.ncbi.nlm.nih.gov

Research setting versus clinic setting: Which produces better outcomes in cognitive therapy for depression? [2021]

5. Iran pubmed.ncbi.nlm.nih.gov

Effect of cognitive processing therapy and holographic reprocessing on reduction of posttraumatic cognitions in students exposed to trauma. [2021]

6. England pubmed.ncbi.nlm.nih.gov

The science of cognitive therapy. [2018]

7. Netherlands pubmed.ncbi.nlm.nih.gov

A meta-analysis of the effects of cognitive therapy in depressed patients. [2022]

8. United States pubmed.ncbi.nlm.nih.gov

A Comparison of Cognitive Processing Therapy and Seeking Safety for the Treatment of Posttraumatic Stress Disorder in Veterans. [2021]

9. Netherlands pubmed.ncbi.nlm.nih.gov

Application of neuropsychology and imaging to brain injury and use of the integrative cognitive rehabilitation psychotherapy model. [2021]

10. Germany pubmed.ncbi.nlm.nih.gov

Benefits of group cognitive remediation therapy in anorexia nervosa: case series. [2018]