The availability of Cognitive Behaviour Therapy for psychosis (CBTp) inThe Netherlands

Background: Although Cognitive Behaviour Therapy for psychosis (CBTp) is a first-choice recommended evidence-based treatment, studies suggest that its availability falls short. This study aimed to assess the availability of CBTp in The Netherlands and to identify factors related to implementation. Method: Online survey among 189 psychosis-specialized teams of 19 mental health organisations, together providing care to approximately 25% of all adults with a psychotic disorder in Dutch mental healthcare. Results: CBTp was available for 19.2 to 26.4% of patients. About a third of the treatments were provided by psychologists untrained in CBTp. Availability was associated with how much the team psychologists were trained in CBTp (r(126) =.477, p <.001) and with the patient to therapist ratio (r(116) = -.757, p <.001). We explored psychologist time use and reflected on how their available hours may be matched to patients’ various treatment needs. Discussion: Most Dutch patients with psychosis do not have access to CBTp. We recommend enhancing therapists’ CBTp skills, allocating protected CBTp time, and increasing the number of psychologists in psychosis teams. 0.37 FTE of psychologists per 100 patients are required solely for CBTp. Further research into comorbid disorder treatment need is recommended to establish staffing guidelines.