What are the key elements of cognitive analytic therapy for psychosis? A Delphi study

ObjectiveThere has been growing interest in the use of cognitive analytic therapy (CAT) with those facing experiences of psychosis. However, there is little research on how CAT is best applied to working with psychosis. This study aimed to identify what the key aspects of CAT for psychosis are or whether this approach requires adaptation when applied to those with experiences of psychosis, drawing on expert opinion. MethodAn adapted Delphi methodology was used. Items were generated during an initial workshop (N=24) and then rated for agreement or importance via an online survey by a sample of experts with experience of CAT and working clinically with psychosis (N=14). ResultsFollowing two rounds of ratings, consensus was reached on most items. Additional comments emphasized the need to be flexible with regard to the varying needs of individual clients. ConclusionsResults highlight the specific relational understanding of psychosis provided by CAT as one of the key elements of this approach. Responses emphasized the need for some level of adaptation to work with psychosis, including greater flexibility with regard to the treatment frame.