Classification of psychotherapy interventions for people with schizophrenia: development of the Nottingham Classification of Psychotherapies

Matthew T Roberts; Farhad Shokraneh; Yanli Sun; Maddie Groom; Clive E Adams

doi:10.1136/ebmental-2020-300151

Classification of psychotherapy interventions for people with schizophrenia: development of the Nottingham Classification of Psychotherapies

Evid Based Ment Health. 2021 May;24(2):62-69. doi: 10.1136/ebmental-2020-300151. Epub 2020 Dec 21.

Authors

Matthew T Roberts¹, Farhad Shokraneh^{2

3}, Yanli Sun⁴, Maddie Groom⁵, Clive E Adams⁶

Affiliations

¹ Academic Foundation Programme, Nottingham University Hospitals NHS Trust, Nottingham, UK, Nottingham, UK Matthew_T_Roberts@outlook.com.
² King's Technology Evaluation Centre, London Institute of Healthcare Engineering, School of Biomedical Engineering and Imaging Sciences, Faculty of Life Sciences and Medicine, King's College London, London, UK.
³ Cochrane Schizophrenia, Institute of Mental Health, Division of Psychiatry and Applied Psychology, School of Medicine, University of Nottingham, Nottingham, UK.
⁴ Perinatal Community Mental Health Team, Lincolnshire Partnership NHS Foundation Trust, Lincoln, UK.
⁵ School of Medicine, Division of Psychiatry and Applied Psychology, University of Nottingham, Nottingham, UK.
⁶ Institute of Mental Health, Division of Psychiatry and Applied Psychology, School of Medicine, University of Nottingham, Cochrane Schizophrenia Group, Nottingham, UK.

Abstract

Background: Currently, there is no accepted system for the classification of psychotherapies for application within systematic reviews. The creation of anuncomplicated, understandable and practical classification system is neccessary for conducting reliable systematic reviews.

Objective: To devise a system for classification of psychotherapy interventions-for use, initially, in systematic reviews.

Methods: Cochrane Schizophrenia's Register used as the source of randomised controlled trial. After being piloted and refined at least twice, finally we applied it to all relevant trials within the register. Basic statistical data already held within the register were extracted and used to calculate the distribution of schizophrenia research by form of psychotherapy.

Findings: The final classification system consisted of six definable broad 'boughs' two of which were further subdivided into 'branches'. The taxonomy accommodated all psychotherapy interventions described in the register. Of the initial 1645 intervention categories within the register, after careful recoding, 539 (33%) were psychotherapies (234 coded as 'Thought/Action' (cognitive & behavioural)-1495 studies; 135 'Cognitive Functioning'-652 studies; 113 'Social'-684 studies; 55 'Humanistic'-272 studies; 23 'Psychoanalytic/dynamic'-40 studies; and 63 'Other'-387 studies). For people with schizophrenia, across categories, the average size of psychotherapy trial is small (107) but there are notable and important exceptions.

Conclusion: We reported a practical method for categorising psychotherapy interventions in evaluative studies with applications beyond schizophrenia. A move towards consensus on the classification and reporting of psychotherapies is needed.

Clinical implications: This classification can aid clinicians, clinical practice guideline developers, and evidence synthesis experts to recognise and compare the interventions from same or different classes.

Keywords: adult psychiatry; child & adolescent psychiatry; delirium & cognitive disorders; forensic psychiatry; schizophrenia & psychotic disorders.

MeSH terms

Cognitive Behavioral Therapy*
Humans
Psychotherapy
Schizophrenia* / therapy
Systematic Reviews as Topic