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Psychosis. 2013 Jan 1;5(3). doi: 10.1080/17522439.2012.704932.

Cognitive Behavioral Therapy for Psychosis - Training Practices and Dissemination in the United States.

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Department of Psychiatry, Columbia University, New York, NY ; New York State Psychiatric Institute, New York, NY.
Department of Psychology, Institute of Psychiatry, King's College, London, United Kingdom.
Department of Psychiatry, New York University Medical Center, New York, NY.
Department of Psychiatry, University of Pennsylvania, Philadelphia, PA.



Cognitive-Behavioral Therapy for psychosis (CBTp) is an evidence-based treatment for psychosis-related disorders. However, despite the strong evidence-base and inclusion in national treatment guidelines, CBTp remains poorly disseminated in the US. It is proposed that this state is a product of lack of CBTp knowledge among clinical training leaders along with limited availability of training opportunities.


We surveyed training directors in US psychiatry residency and clinical psychology doctoral programs to characterize the penetration of CBTp training and to assess their familiarity with basic CBTp facts.


Directors displayed limited knowledge of CBTp effectiveness, with only 50% of psychiatry and 40% of psychology directors believing that CBTp is efficacious. Only 10% of psychiatry and 30% of psychology directors were aware that the CBTp evidence-base is based on meta-analyses. While 45% of all directors reported that their program offer CBTp training, trainees received limited training - 4 hours of didactics, 21 hours of treatment, and 12 hours of supervision.


CBTp dissemination in the US is characterized by training directors' minimal awareness of the CBTp evidence-base along with training opportunities that are so limited, as to be unlikely to be adequate to provide CBTp effectively, hence unlikely to improve patients' psychoses.

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