Increasing access to CBT for psychosis patients: a randomized controlled trial evaluating a brief, targeted CBT-informed intervention for distressing voices delivered by Assistant Psychologists (the GiVE3 study)
In brief
Assistant-psychologist delivered CBT does not ease distressing voices
In a pragmatic trial of 135 people with psychosis, a brief, guided self-help CBT program delivered by assistant psychologists showed no significant reduction in auditory hallucination distress compared with treatment-as-usual at 16 and 28 weeks (effect size around -0.3). The findings suggest that brief therapist training may be insufficient to achieve clinical benefit, highlighting the need for more intensive or specialist delivery.
- Journal
- Psychotherapy and psychosomatics (Q1)
- Published
- 7 August 2026
- Study design
- Randomized controlled trial
- Evidence level
- Level 1, High (CEBM 1b)
- Authors
- Mark Hayward, Katherine Berry, Anna-Marie Bibby-Jones, Stephen Bremner, Kate Cavanagh, Marsha Cochrane, et al.
- PMID
- 42566386
- DOI
- 10.1159/000553617
Why clinicians should know about it
- Picked for Family Practice (top studies of the week, 9 August 2026).
- Picked for Health Policy (top studies of the week, 9 August 2026).
- Picked for Psychiatry and Mental Health (top studies of the week, 9 August 2026): CBT for psychosis voices, not mood‑disorders
Abstract
Background Cognitive Behaviour Therapy for psychosis (CBTp) is recommended for treating psychosis. However, access to CBTp is extremely poor for patients internationally due to its intensive nature and delivery by highly trained therapists. This study evaluated the clinical and cost effectiveness of the GiVE intervention (Guided self-help CBT for distressing voices) delivered by briefly trained therapists (Assistant Psychologists). Methods This study was a pragmatic, two-arm, parallel group, superiority randomised controlled trial, comparing the GiVE intervention (delivered by Assistant Psychologists) in addition to treatment-as-usual (TAU) to TAU alone, recruiting patients with psychosis across three National Health Service sites in the UK, using 1:1 allocation and blinded post-treatment and follow-up assessments. Clinical and health economic outcomes were assessed at baseline, 16 weeks, and 28 weeks. The primary outcome was the Psychotic Symptom Rating Scale - Auditory Hallucinations Distress Scale (PSYRATS-AH Distress). Results In total, 135 participants were randomised: 68 to GiVE plus TAU, 67 to TAU alone. Participant's mean age was 43.8 years (SD=12.1; range 18-69), 44 (33%) were women, 88 (65%) men, and 2 (1%) non-binary. For the intention-to-treat analysis, adjusted between-group differences in mean PSYRATS-AH Distress were -0·73 (95% CI -2·34 to 0·88; p=0·376; Cohen's d=-0·35) at 16-weeks and -0·61 (95% CI -2·23 to 1·01; p=0·460; Cohen's d=-0·30) at 28-weeks in favour of GiVE plus TAU but were not statistically significant. Conclusion Our study found that the GiVE intervention was not clinically effective in treating distressing voice hearing experiences when delivered by briefly trained Assistant Psychologists to psychosis patients.
Abstract as published, via PubMed.
For healthcare professionals. The summary is generated by AI from the published abstract, and the evidence level is assigned automatically from the study design on the Oxford CEBM hierarchy. Neither is medical advice. Read the full paper before changing practice.