2026 Autumn Workshop 6

Scientific background and outline

People with psychosis have high rates of trauma exposure and post-traumatic stress-disorder (PTSD), which is associated with worse clinical outcomes. However, concerns about implementing trauma-focused therapies in psychosis are common, due to concerns about iatrogenic harm. Further, the complexity of psychosis and trauma effects presents a challenge for clinicians in determining how to intervene. This workshop will address these issues by providing an overview of the evidence relating to trauma therapies in psychosis. The therapeutic model and therapy guide (Keen, Hardy et al., 2026) employed in the STAR (Study of Trauma and Recovery) trial (Peters et al., 2025; 2026), the largest RCT for trauma therapy in psychosis, will be introduced. Based on theoretical models highlighting the interplay between PTSD and psychosis, the therapy targets evidence-based psychological mechanisms that play a role in both. The workshop will be illustrated with case examples and lived experience testimonials. Learning will be supported with clinical and reflective; teaching will be co-delivered by an expert-by experience.

Implication for everyday clinical practice of CBT

Trauma survivors with psychosis should be offered effective evidence-based trauma focused therapies for their PTSD, rather than clinical services and research inadvertently continuing to perpetuate their silence through exclusion. This workshop aims to empower clinicians to feel able to support people to make sense of their experiences and to deliver Trauma-focused Cognitive Behavioural Therapy for Psychosis (TF-CBTp) when indicated to reduce distressing symptoms of PTSD and psychosis.

The workshop is aimed at HCPC and/or BABCP accredited clinicians working with individuals with psychosis.

Key learning objectives

By the end of this workshop, participants will be able to:

• Define trauma and describe its relationship to psychosis.

• Understand the background, evidence base and theory regarding the relationship between PTSD and psychosis

• Develop knowledge and confidence to collaboratively support trauma survivors with PTSD and psychosis to formulate and make sense of their experiences.

• Apply the STAR TF-CBTp therapy guide to promote recovery and reduce distressing experiences in trauma survivors with PTSD and psychosis.

Biography

Dr Nadine Keen is a Consultant Clinical Psychologist and Clinic Coordinator of the award-winning Psychological Interventions Clinic for Outpatients with Psychosis (PICuP) at South London and Maudsley NHS Trust, London, UK. Nadine has specialised in supporting people affected by trauma and psychosis for over 20 years and is committed to improving access to effective psychological therapies for underserved and marginalised groups.

Nadine was a co-applicant and co-therapy lead on the large NIHR-funded, UK multicentre randomised controlled trial, the STAR (Study of Trauma and Recovery) trial, which evaluated the effectiveness of TF-CBTp for individuals with PTSD and distressing psychosis. Nadine is passionate about translating research into clinical practice and delivers regular national and international training, teaching, and workshops on trauma, psychosis, and psychological therapies. Alongside her clinical and training roles, she remains actively involved in research and supervises doctoral projects at the Institute of Psychiatry, Psychology & Neuroscience (IoPPN), King’s College London.

Key references  

Keen, N., Hardy, A., Bowe, S., Peters, E., Dudley, R., Grey, N., Varese, F., Longden, E., Steel, C., & Morrison, A., & the STAR Group (2026). Empowering the silenced: The STAR (Study of Trauma And Recovery) therapy guide for delivering integrated Trauma-Focused Cognitive Behaviour Therapy for psychosis (TF-CBTp). Psychosis. Advance online publication. https://doi.org/10.1080/17522439.2026.2719534

Peters, E., Swan, S., Underwood, R., Jafari, H., Varese, F., Steel, C., Dudley, R., Greenwood, K., Emsley, R., Keen, N., Bowe, S., Hardy, A., Morrison, A., & the STAR Group. (2026). Trauma-focused therapy integrated with

cognitive behavioural therapy for psychosis for people with post-traumatic stress disorder and psychosis (the STAR trial): A multicentre, pragmatic, randomised trial in the UK. The Lancet Psychiatry, 13(7), 549–566. https://doi.org/10.1016/S2215-0366(26)00090-8

Hardy, A., Keen, N., van den Berg, D., Varese, F., Longden, E., Ward, T., & Brand, R. M. (2024). Trauma therapies for psychosis: A state‐of‐the‐art review. Psychology and Psychotherapy: Theory, Research and Practice, 97(1), 74–90. https://doi.org/10.1111/papt.12387

Peters, E., Hardy, A., Dudley, R., Varese, F., Greenwood, K., Steel, C., Emsley, R., Keen, N., Bowe, S., & Swan, S. (2022). Multisite randomised controlled trial of trauma-focused cognitive behaviour therapy for psychosis to reduce post-traumatic stress symptoms in people with co-morbid PTSD and psychosis: Study protocol for the STAR trial. Trials, 23(1), 429. https://doi.org/10.1186/s13063-022-06460-x