Cognitive behaviour therapy for psychosis in high secure services: An explanatory hermeneutic review of the international literature

Background: Mainstream psychological interventions may need adaptation in High Secure 9 (HS) healthcare contexts to enable better recovery, safeguard the public and offer 10 economic value. One specific psychological intervention, cognitive behavioural therapy\ud 11 for psychosis (CBTp), has an already proven efficacy in aiding recovery in non-forensic\ud 12 populations, yet its impact in HS settings has received considerably less research attention.\ud 13 Aims: This exploratory review catalogues CBTp approaches used in HS hospitals and\ud 14 appraises impact through the inclusion of both fugitive literature and peer reviewed research.\ud 15 Method: A pragmatic approach was utilized through an iterative literature search strategy and\ud 16 hermeneutic source analysis of the identified studies. Results: Fourteen studies were identified\ud 17 from HS contexts from within the UK and internationally. These included group, individual\ud 18 therapy and CBTp linked milieus. Conclusions: CBTp is an active component of treatment in\ud 19 HS contexts. Some modes of delivery seem to have greater levels of efficacy with more typical\ud 20 HS patients. The literature indicates key differences between HS and non-HS applied CBTp.\ud 21 Continued application and evaluation of CBTp in HS conditions is warranted