(PS10-12) Bridging the Gap: A Literature Review on Implementing CBT for Psychosis in Forensic Settings

Cognitive Behavioral Therapy for psychosis (CBTp) is a therapeutic method aimed at addressing symptoms spanning psychotic spectrum disorders with the goal of reducing distress and improving functioning. The utility of CBTp within clinical inpatient and outpatient populations has been demonstrated across the existing literature, and its robust evidence has resulted in its recognition as the first-line psychological intervention for psychosis in the U.S. and U.K. However, until recently, the efficacy of CBTp in high security forensic mental health or correctional settings has been largely underexplored. As such, this systematic literature review aims to compile the existing research investigating CBTp’s efficacy compared to treatment as usual (TAU) within high security forensic settings. 

A thorough search of online databases was conducted to identify relevant studies for review. Eligibility for inclusion included peer-reviewed studies comparing symptom outcomes of CBTp and TAU within high security forensic and/or correctional settings . Studies that were not published, or did not examine forensic samples were the only criteria for exclusion. The reviewed literature revealed evidence of greater improvements in negative symptoms with CBTp than those produced with TAU, with varied effects on delusions and hallucinations. Further, some studies reported alleviation of affective disturbances as well as notable improvements in interpersonal functioning as additional benefits of CBTp treatment. These findings underscore CBTp's potential as a viable treatment option in high security forensic settings. This review concludes with a discussion of the practical implications of these findings and suggested adaptations to tailor CBTp for high security settings.