Pilot-Case-Series Combining Symptom-Specific Group & Ultra-Brief Individual Cognitive Behavioural Therapy for Negative Symptoms in an Early Intervention in Psychosis Service.

Following a first episode of psychosis (FEP) the majority of patients experience at least one negative symptom (NS) to a severe degree (an der Heiden et al., 2016; Mezquida et al., 2017). However, there is limited research on the efficacy of cognitive behavioural therapy for psychosis (CBTp) for NSs, especially for group CBTp (gCBTp) following a FEP. Yet, group interventions can be more therapeutic in this typically younger patient group (Albiston et al., 1998; Orfanos et al., 2015). The present pilot-case-series investigated the feasibility, acceptability, safety and satisfaction of combining ultra-brief one-to-one and gCBTp for NSs for patients following a FEP. Six medication resistant patients with entrenched NSs attended at least half of the six one-to-one and gCBTp sessions. Both clinician-rated scales, including the Scale for the Assessment of Negative Symptoms (SANS; Andreasen, 1983) and Global Assessment of Functioning (GAF; Hall, 1995), and patient-rated scales including the Subjective Experience of Negative Symptoms Scale (SENS; Selten et al., 1993), were used to evaluate clinically significant and reliable (CSR) change. Half of the patients showed CSR improvements on the SANS and GAF symptom (GAF-S) domain. Two patients showed CSR improvements on the GAF disability (GAF-D) domain. On the SENS, five patients reported clinically significantly improvements. Patients provided their satisfaction ratings and charted their SENS distress-bother scores weekly to track progress. Overall, the present study offers a useful clinical template, synergistically combining one-to-one and gCBTp, exclusively focusing on a single-symptom group and intervening early to aid in the treatment of NSs. September 2025.