The interventions began with the motivational interviewing
phase and five initial weekly sessions designed to assess and then
enhance the patient’s motivation to change. If the patient’s commitment
was obtained, changes in substance use were negotiated
on an individual basis. With the introduction of the individual
cognitive behavior therapy at week 6 (or earlier if appropriate),
the motivational interviewing style was integrated into subsequent
cognitive behavior therapy sessions. The individual cognitive
behavior therapy took place over approximately 18 weekly
sessions, followed by six biweekly sessions (a total of 29 individual
sessions, including the motivational interviewing).
Following assessment of both patients and caregivers, shared
goals were generated that became the focus of conjoint patient/
family sessions. The family intervention consisted of 10–16 sessions,
some of which took the form of integrated family/patient
sessions, some of which involved family members alone.
All of the clinicians involved in the trial received training in
motivational interviewing style from an experienced interviewer
with extensive training in the techniques ( J.M.). Six clinicians
(five clinical psychologists [C.B., G.H., J.McG., N.T., and Ian Lowens]
and one nurse therapist [R.O.]) conducted the cognitive behavior
therapies (individual and family). All had experience in
cognitive behavior therapy work with psychotic patients and were
eligible for accreditation as cognitive behavior therapists with the
British Association for Behavioural and Cognitive Psychotherapy.
Therapy was detailed in a comprehensive treatment manual
(available from C.B.), and the therapists received weekly supervision
based on audiotaped sessions to ensure treatment fidelity.
The interventions began with the motivational interviewingphase and five initial weekly sessions designed to assess and thenenhance the patient’s motivation to change. If the patient’s commitmentwas obtained, changes in substance use were negotiatedon an individual basis. With the introduction of the individualcognitive behavior therapy at week 6 (or earlier if appropriate),the motivational interviewing style was integrated into subsequentcognitive behavior therapy sessions. The individual cognitivebehavior therapy took place over approximately 18 weeklysessions, followed by six biweekly sessions (a total of 29 individualsessions, including the motivational interviewing).Following assessment of both patients and caregivers, sharedgoals were generated that became the focus of conjoint patient/family sessions. The family intervention consisted of 10–16 sessions,some of which took the form of integrated family/patientsessions, some of which involved family members alone.All of the clinicians involved in the trial received training inmotivational interviewing style from an experienced interviewerwith extensive training in the techniques ( J.M.). Six clinicians(five clinical psychologists [C.B., G.H., J.McG., N.T., and Ian Lowens]and one nurse therapist [R.O.]) conducted the cognitive behaviortherapies (individual and family). All had experience incognitive behavior therapy work with psychotic patients and wereeligible for accreditation as cognitive behavior therapists with theBritish Association for Behavioural and Cognitive Psychotherapy.Therapy was detailed in a comprehensive treatment manual(available from C.B.), and the therapists received weekly supervisionbased on audiotaped sessions to ensure treatment fidelity.
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