ArticlesCognitive-Behavioral Therapy in Intensive Case Management: A Multimethod Quantitative-Qualitative StudyJetté Pomerleau, Vincent MD, MSc; Demoustier, Arnaud Inf; Krajden, Rosanne V. MSc; Racine, Hélène MSc, MAP, PPCC; Myhr, Gail MD, CM, FRCPC Author Information POMERLEAU: Department of Psychiatry, McGill University, Montréal, QC, Canada DEMOUSTIER: École des Sciences infirmières, University of Sherbrooke, Sherbrooke, QC, Canada KRAJDEN: Department of Psychology, Concordia University, Montréal, QC, Canada RACINE: at the time the article was prepared, McGill University Heath Centre, Montréal, QC, Canada MYHR: Department of Psychiatry, McGill University and McGill University Health Centre, Montréal, QC, Canada The authors declare no conflicts of interest. Please send correspondence to: Gail Myhr, MD, CM, FRCPC, 1033 Avenue des Pins, Montréal, QC, Canada H3A 1A1 (e-mail: [email protected]). Journal of Psychiatric Practice: May 2022 - Volume 28 - Issue 3 - p 203-217 doi: 10.1097/PRA.0000000000000637 Buy Metrics Abstract Cognitive-behavioral therapy (CBT) has been shown to improve clinical outcomes in schizophrenia and severe and persistent mental illness, but access to it remains limited. One potential way to improve access to CBT is to provide it through intensive case management (ICM) teams. A 90-week quality improvement study was designed to assess if CBT could be implemented in ICM teams. Self-selected ICM clinicians (N=8) implemented CBT with their patients (N=40). These clinicians attended weekly seminars (36 h total) and group supervision (1.5 h/wk). Patient outcomes for this group were compared with those of other clinicians who did not attend the seminars [treatment as usual (TAU) clinicians (N=4)] and their patient population (N=49). Prescore and postscore on the Clinical Global Impressions scale and a quality-of-life scale (Montreal Life Skill Survey) were analyzed for completers in both groups (Clinical Global Impressions scores were analyzed for 25 patients in the CBT group and 29 patients in the TAU group). Weekly session reports by clinicians in the CBT group measured CBT interventions, session focus, and satisfaction with CBT. Qualitative data were obtained from clinicians in the CBT group. After 90 weeks, patients in the CBT group had fewer negative symptoms compared with patients in the TAU group. Our qualitative data describe 2 trajectories of patients: those who improved with CBT and those who did not, and they suggest factors that may impact patient trajectories in CBT. This study suggests that CBT can be used effectively in ICM teams working with patients suffering from severe and persistent mental illness. Copyright © 2022 Wolters Kluwer Health, Inc. All rights reserved.