O'Driscoll, CW; (2014) Process Analysis of Trauma Focused CBT for Individuals with Schizophrenia. Doctoral thesis , UCL (University College London).

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Abstract

This volume is in three parts. Part 1 is a meta-analysis and literature review investigating the role of cognitive emotion regulation strategies in schizophrenia, with dissociation and alexithymia as possible mediators. It summarises the evidence on a conceptual link between these variables and their possible importance within schizophrenia in relation to both assessment and treatment. The review and meta-analyses suggested large effects for the maladaptive use of cognitive emotion regulation strategies in schizophrenia compared to healthy controls. The role of dissociation, its sub-categories, and alexithymia are also discussed. Clinical and research implications are then postulated. Part 2 describes an empirical study that investigated in-session process variables in trauma focused CBT for individuals with schizophrenia. The working alliance, emotional processing, affect arousal and primary emotions were investigated at early and late phase of therapy. A subgroup of participants who experienced child trauma (as opposed to adult trauma only) was also explored. The results showed no difficulty in engagement or suitability for this focus of therapy and participants appear to have the capacity to undertake the cognitive-emotional demands inherent in the treatment. The process analysis had limitations and recommendations are given for clinical practice and future research. Part 3 is a critical appraisal that gives reflections on the application of process analysis within clinical CBT trials. It discusses issues regarding conceptualising specific vs. non-specific variables in CBT research, study design and measurement. It offers some suggestions and recommendations when considering research in this area.

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