Publication Details

This article was originally published as: Mcleod, HJ, Deane, FP & Hogbin, B, Changing staff attitudes and empathy for working with people with psychosis, Behavioural and Cognitive Psychotherapy, 2002, 30(4), 459-470. Copyright 2002 Cambridge University Press. Journal information can be found here.


Seventy-seven mental health professionals completed a 3-day cognitive behavioural training course for managing hallucinations and delusions in schizophrenia. A questionnaire measuring attitudes and empathy towards working with people who have these symptoms was administered before and after the course. Significant increases in feelings of adequacy, legitimacy, employment related self-esteem, and expectations of work satisfaction were observed after the course and participants displayed high levels of motivation for working with this clinical population at both time points. In addition, the participants showed significant increases in perceived empathy for the experience of hallucinations and delusions. This was a predicted outcome as the course included exercises designed to enhance therapists’ understanding of the subjective experience of psychotic symptoms. Empathy is recognized in the wider psychotherapy outcome literature as a therapeutically important variable that influences the formation of a therapeutic alliance but it is a relatively unexamined construct in CBT for psychosis. Further investigations in this area will potentially enhance psychological treatment delivery and subsequent outcomes for people who experience hallucinations and delusions. Furthermore, explication of such ‘‘non-specific’’ therapeutic factors may help to explain some of the transient but beneficial effects of unstructured ‘‘control’’ therapies observed in recent CBT for psychosis outcome trials.



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