The effectiveness and tolerability of trauma‐focused psychotherapies for psychotic symptoms: A systematic review of trauma‐focused psychotherapies

Introduction Psychological trauma is an established risk factor for psychosis. Trauma‐focused psychotherapies (TFPT) have been suggested as a potential treatment for reducing psychotic symptoms in those who have experienced trauma. We therefore sought to investigate the effectiveness, tolerability, and acceptability of TFPT for psychotic symptoms. Methods We conducted a systematic review of studies of any form of TFPT that measured psychotic symptoms across a broad range of diagnoses. Results From 2584 papers initially identified, 17 studies (857 participants) met eligibility criteria. TFPT were found to be well tolerated, with very few adverse events. Acceptability was also high, with a mean dropout rate of 20%. Conclusions Whilst the evidence of effectiveness for TFPT in reducing psychotic symptoms is weak, we found tentative evidence in favour of exposure‐based interventions. Methodologically rigorous trials investigating the efficacy of TFPT for the treatment of psychotic symptoms are needed to assess this promising intervention.