Barrowclough 2001.

Methods	Allocation: randomised Blinding: assessor blind Location: Tameside and Glossop, Stockport and Oldham, UK Length of follow‐up: 18 months
Participants	Diagnosis: schizophrenia or schizoaffective disorder (ICD‐10 and DSM‐IV criteria) N = 36 Sex: 33 M, 3 F Age: 18 ‐ 65 years, mean ˜ 31 years, SD ˜10 years Included: length of illness: unclear, meeting DSM‐IV criteria for substance abuse or dependence, in current contact with mental health services, a minimum of 10 hours of face‐to face contact with the caregiver per week Excluded: organic brain disease, clinically significant concurrent medical illness, or learning disability
Interventions	1. CBT group*: N = 18 Content: "The interventions began with the motivational interviewing phase and five initial weekly sessions designed to assess and then enhance the patient’s motivation to change. If the patient's commitment was obtained, changes in substance use were negotiated on an individual basis. With the introduction of the individual cognitive behavior therapy at week 6 (or earlier if appropriate), the motivational interviewing style was integrated into subsequent cognitive behavior therapy sessions." (page 1707) Delivered by: Six clinicians (five clinical psychologists and one nurse therapist) conducted the cognitive behaviour therapies (individual and family). All had experience in cognitive behaviour therapy work with psychotic patients and were eligible for accreditation as cognitive behaviour therapists with the British Association for Behavioural and Cognitive Psychotherapy. Therapy was detailed in a comprehensive treatment manual (available from CB), and the therapists received weekly supervision based on audio‐taped sessions to ensure treatment fidelity. Frequency: 18 weekly sessions, followed by six biweekly sessions 2. Standard care group: N = 18 Content: Routine care in the context of the National Health Service of Great Britain consists of psychiatric management by the clinical team, coordinated through case management and including maintenance antipsychotic medication, monitoring through outpatient and community follow‐up, and access to community‐based rehabilitative activities, such as day centres and drop‐in clinics. All of the patients in the integrated treatment program also received routine care. Delivered by: the clinical team Frequency: not reported Treatment duration: 29 weeks
Outcomes	Global state: relapse Mental state: general, positive symptoms, negative symptoms (PANSS scores) Adverse events: death Functioning: general (GAF scores), social (SFS scores) Satisfaction with treatment: leaving the study early
Notes	Pilot study for Barrowclough 2010 * Participants in CBT group also received the standard care intervention.
Risk of bias
Bias	Authors' judgement	Support for judgement
Random sequence generation (selection bias)	Low risk	Quote: "Individual patients were allocated to each condition by a third party with no affiliation to the study who used a computer‐generated randomization list stratified for sex and three types of substance use (alcohol alone, drugs alone, or drugs and alcohol) to ensure equal male‐female and substance use representation in each arm of the trial." (p.1707) Comment: Computer‐generated randomisation list was used.
Allocation concealment (selection bias)	Low risk	Quote: "allocated to each condition by a third party with no affiliation to the study." (p.1707) Comment: Allocation was concealed sufficiently.
Blinding of participants and personnel (performance bias) All outcomes	High risk	Comment: Participants were not blinded to allocation.
Blinding of outcome assessment (detection bias) All outcomes	Low risk	Quote: "The assessors were blind to treatment allocation; attempts to maintain their blindness included use of separate rooms and administrative procedures for project staff, multiple coding of treatment allocations, and requesting subjects not to disclose information about the treatment." (p.1707) Comment: Assessor was blinded.
Incomplete outcome data (attrition bias) All outcomes	Low risk	Comment: 8 of 36 participants left the trial early, which was a relatively acceptable amount of dropout.
Selective reporting (reporting bias)	Low risk	Comment: all data reported
Other bias	Low risk	Comment: no other risks identified