Cognitive Behavior Therapy for Psychosis: From Understanding to Treatment

Abstract

Abstract Recent randomized controlled trials carried out in the UK suggest that there is now strong evidence for the efficacy of cognitive behavioral therapy in the management of people with chronic treatment resistant psychosis. At the core of this approach is a focus on the subjective needs of people with psychosis (in particular the experience of voices, paranoia, delusions, and depression) and an attempt to understand or make sense of these problems from the individual's perspective. The cognitive behavioral offers both a new set of therapeutic skills, which may be utilized by psychiatric rehabilitation practitioners (see Kuipers and Turkington), and a new way of thinking about the needs of people with psychosis. The implications of the cognitive behavioral model of people with chronic psychosis can therefore inform an approach to psychiatric rehabilitation in which goals of rehabilitation genuinely reflect the concerns of the individual with mental illness. In this paper we outline the clinical implication of recent research findings and illustrate the application of cognitive behavioral formulation and therapy to the management of complex cases of psychosis.