Emotion regulation relates to clinical characteristics and quality of life but not daily functioning in psychosis spectrum outpatients.

Difficulties in emotion regulation (ER) can negatively impact the clinical course and outcomes of a range of psychiatric conditions, including psychosis spectrum disorders. Individuals with psychosis may exhibit poorer ER abilities, which have been associated with increased severity and distress of psychotic symptoms. A paucity of research has investigated the clinical correlates of ER in psychosis and the influence of these difficulties on indices of recovery, such as daily functioning and quality of life. In the present study, 59 outpatients presenting for Cognitive Behaviour Therapy for psychosis (CBTp) in a large psychiatric hospital completed an intake assessment of clinician-rated and self-reported measures prior to treatment. Poor ER abilities were positively correlated with positive symptoms (overall and delusions), social anxiety, depression, and self-reflectiveness and negatively correlated with quality of life and personal recovery. Multiple regression analyses showed ER was a significant predictor of quality of life but not daily functioning, which was predicted most by cognition and psychiatric symptoms. Overall, findings support the clinical utility of assessing emotion dysregulation in psychosis and provide a more nuanced understanding of how such challenges differentially influence recovery in psychosis, which can further inform treatment planning and intervention.

Increasing Access to CBT for Psychosis: Development, Feasibility, and Acceptability of a Specialized Outpatient Service.

Despite the increasing demand for cognitive behavioural therapy for psychosis (CBTp), the existing literature is lacking in terms of models for sustainable implementation. The aims of this study were to: (a) describe the development of a specialized CBTp Service; (b) report demographic characteristics and referral patterns over 1 year to examine feasibility; and (c) review feedback from participants in group-based CBTp to examine acceptability. Data were analyzed from 126 referrals (M = 35.52, SD = 13.06, 59.5% men) to an outpatient CBTp Service at the Centre for Addiction and Mental Health (Toronto, Ontario) between January 2019 to January 2020. Anonymous feedback was obtained from 54 individuals who completed group-based CBTp. Positive symptoms and distressing emotions were the main reasons for referral. Over half of eligible referrals scheduled an intake assessment and 70% of individuals who completed this assessment attended further treatment. Primary reasons for service refusal were scheduling conflicts and illness-related barriers. The total service wait-time was two months, with the longest delay between dates of referral and initial contact. Satisfaction with the quality of CBTp and its components was rated high among group members. Although variable wait-times and engagement levels were identified across stages of the referral process, the CBTp Service demonstrates preliminary feasibility and acceptability, and provides a model of service delivery to incorporate within future CBTp implementation efforts in Canada.