Improving implementation of evidence based practice for people with psychosis through training the wider workforce: Results of the GOALS feasibility randomised controlled trial. (June 2018)

• Record Type: Journal Article
• Authors: Waller, Helen; Landau, Sabine; Fornells-Ambrojo, Miriam; Jolley, Suzanne; McCrone, Paul; Halkoree, Rikesh; Basit, Nedah; Iredale, Catherine; Tunnard, Catherine; Zala, Darshan; Craig, Tom J.K.; Garety, Philippa
• Is Part Of: Journal of behavior therapy and experimental psychiatry. Volume 59(2018)
• Page Start: 121
• Page End: 128
• Publication Date: 2018-06
• Subjects: Implementation -- Goal attainment -- Recovery -- Feasibility -- Workforce training; Behavior therapy -- Periodicals; 616.89142
• DOI: 10.1016/j.jbtep.2017.12.004
• Languages: English
• ISSNs: 0005-7916

Abstract

Abstract: Background and objectives: There is a pressing need to improve access to evidence-based practice for people with psychosis. The primary aim of this study was to assess clinical feasibility of a manualised, evidence-based CBT intervention (GOALS) targeting a personalised recovery goal, delivered by the frontline workforce, following brief training. Secondly, we aimed to conduct preliminary statistical analyses of key outcomes and costs. Methods: The GOALS study is a feasibility randomised controlled trial (ISRCTN 73188383). 75 participants with current psychosis were recruited and randomly allocated to receive either treatment as usual alone or with GOALS therapy. Results: Brief training enabled frontline staff to deliver the therapy according to protocol and 74% of therapy participants partially or fully achieved their goals. There were significant improvements with a moderate effect size of 0.56 on goal attainment. However, preliminary statistical analyses found no significant differences between groups on our primary outcome of activity levels or other secondary outcomes Health economic analysis found that point estimates of costs, controlling for baseline costs, implied savings (even including intervention costs), but the difference was not statistically significant. Limitations: The study was designed as a feasibility RCT, and therefore the results of secondary estimates of efficacy effects should be treated with caution. Conclusions: This approach holds promise in supporting people with psychosis to reach personal recovery goals, cost effectively. Highlights: Following training, mental health staff delivered GOALS therapy according to protocol. Those randomised to GOALS were significantly more likely to achieve recovery goals. Health economics suggested cost-savings for the therapy. There were implementation challenges for those in case management roles. GOALS holds promise in enabling people to reach recovery goals cost effectively.