title: CHoice of Outcome In Cbt for psychosEs (CHOICE): the development of a new service user-led outcome measure of CBT for psychosis.
abstract: Outcome measures for cognitive behavior therapy for psychosis (CBTp) have been derived from pharmacological studies, focusing on symptom change rather than outcomes such as distress or fulfillment. This study presents the development and psychometric properties of a new outcome measure (CHoice of Outcome In Cbt for psychosEs [CHOICE]), which reflects more strongly the aims of CBTp and the priorities of service users. Service users who had received CBTp participated in focus groups to discuss their outcome priorities, using a topic guide generated by a panel of experts in CBTp. A qualitative thematic analysis was undertaken to reach consensus on themes and generate items. Response scales were constructed for 3 dimensions: severity, satisfaction, and importance. The resulting questionnaire was piloted with service users who had not received CBTp, stratified by service type, ethnicity, and first language to ensure that it was user friendly and applicable prior to CBTp. The psychometric properties of the measure were then examined in a sample of 152 service users. Twenty-four items, and 2 of the dimensions (severity and satisfaction), were retained in the final measure. A factor analysis revealed a single psychological recovery factor interspersed throughout with both CBTp and recovery items. Test-retest reliability, construct validity, and sensitivity to change following CBTp were confirmed. The CHOICE measure is unique in being the first psychometrically adequate service user-led outcome measure of CBTp. It provides the opportunity to examine the evidence base for CBTp with an assessment approach that prioritizes service user definitions of recovery and CBT aims.
authors.affiliation: Department of Psychology, Maudsley Psychology Centre, Maudsley Hospital and Institute of Psychiatry, De Crespigny Park, Denmark Hill, London SE5 8AF, UK. k.greenwood@iop.kcl.ac.uk
authors.forename: Kathryn E
authors.initials: KE
authors.lastname: Greenwood
authors.forename: Angela
authors.initials: A
authors.lastname: Sweeney
authors.forename: Sally
authors.initials: S
authors.lastname: Williams
authors.forename: Philippa
authors.initials: P
authors.lastname: Garety
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Kuipers
authors.forename: Jan
authors.initials: J
authors.lastname: Scott
authors.forename: Emmanuelle
authors.initials: E
authors.lastname: Peters
mesh_terms: D000328:Adult; D003697:Delphi Technique; D005260:Female; D017144:Focus Groups; D005500:Follow-Up Studies; D006801:Humans; D007406:Interview, Psychological; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care / Q000706:statistics & numerical data*; D017060:Patient Satisfaction; D011569:Psychiatric Status Rating Scales / Q000706:statistics & numerical data; D011594:Psychometrics; D016032:Randomized Controlled Trials as Topic / Q000706:statistics & numerical data; D015203:Reproducibility of Results; D012559:Schizophrenia / Q000175:diagnosis / Q000628:therapy*; D012565:Schizophrenic Psychology; D055815:Young Adult