Measuring Practitioner Attitudes Toward Psychosis and Recovery: Exploratory Factor Analysis of the Psychosis Attitudes Scale.

Objective: Practitioner attitudes regarding the nature of psychosis and prospects of recovery are important targets in supervision and training of practitioners who work therapeutically with this population. The 19-item Psychosis Attitudes Scale (PAS) was developed as a way to monitor changes in psychosis-related attitudes among practitioners being trained in an Evidence Based Treatment (EBT) for psychosis. This study reports the development and underlying factor structure of the PAS. Method: Three hundred twenty-five community mental health clinicians completed the PAS following a Cognitive Behavioral Therapy for psychosis (CBTp) multiday workshop training. We conducted an exploratory factor analysis to investigate the underlying structure of the initial set of items. Results: Our analyses suggest that the PAS taps into four attitude groupings, which can be conceptualized as perceived confidence in working with individuals with psychosis (Factor 1), a recovery orientation (Factor 2), expectations of fulfillment (Factor 3), and a stress-vulnerability orientation (Factor 4). Conclusions and Implications for Practice: Factors 1 and 3 appear to tap into general themes relevant to training practitioners in an evidence-based psychotherapeutic intervention for psychosis. Factors 2 and 4 are consistent with guiding principles of high-fidelity CBTp. At the individual level, practitioner attitudes have implications for training retention and treatment delivery. At the organizational level, the collective attitudes of staff in a given setting may serve as an indicator of readiness for EBT for psychosis implementation. Impact and Implications: The Psychosis Attitudes Scale (PAS) appears to tap into practitioner's self-confidence in working with individuals with psychosis, recovery orientation, expectations of professional fulfillment, and adoption of a stress-vulnerability framework for conceptualizing psychosis risk. As these themes are relevant to competent delivery of Cognitive Behavioral Therapy for psychosis (CBTp), the PAS appears to have utility as a process measure for training and supervising practitioners who work therapeutically with individuals with psychosis. [ABSTRACT FROM AUTHOR]