Community mental health practitioners have an ethical responsibility to deliver treatments with the highest demonstrated efficacy. CBT is the psychosocial treatment with the greatest demonstrated efficacy for schizophrenia. Therefore, clinicians who work with schizophrenia should deliver cognitive-BT to patients diagnosed with schizophrenia. However, relative to UK clinicians are also less confident about the efficacy of CBT, suggesting a relationship between therapeutic optimism and clinical practices
Differences between British and American clinicians in the treatment of schizophrenia may suggest fundamental differences in health care delivery systems, in national attitudes towards clinical research, or in etiological theories of schizophrenia. The recent requirement of demonstrable competency in CBT among psychiatry residency graduates may help bring US clinicians into greater agreement with their British counterparts in this area. Further, as the US health care system continues to move towards evidence-based practices, clinicians treating schizophrenia will encounter greater pressure to deliver empirically validated treatments. It will be increasingly important to identify the environmental barriers and attitudinal factors preventing US clinicians from providing a treatment with the greatest likelihood of success