Implementing Cognitive-Behavioral Therapy for People With Psychosis: Local and National Initiatives in the United Kingdom

International treatment guidelines recommend cognitive-behavioral therapies for people with psychosis, but implementation remains problematic. This column reports on local work to improve implementation and two recent initiatives by the National Health Service in England. The aim is to operationalize key facilitators of implementation, including adequate training, time for delivery, and supervision; systems to identify the target caseload and monitor access, provision, and outcomes; effective pathways for offering and delivering therapy; and organizational support. With these facilitators in place, new investment translates readily into effective delivery. Still, achieving universal access to cognitive-behavioral therapies may require an alternative model.