CBT for Psychosis

Question 1

What is CBTp used for?

Answer 1

• To provide treatment for symptoms of SZ that persist despite medication
• Many patients are left with persistent positive & negative symptoms, CBT aims to deal with these and improve patients’ functioning generally

Question 2

How does CBT work?

Answer 2

• Patients encouraged to evaluate content of their delusions/voices & test validity of their beliefs
• They’re set behavioural assignments to improve functioning
• Distorted thinking & maladaptive beliefs are identified with help of therapist, looking for alternative explanations & coping strategies

Question 3

What are the 6 stages of CBT?

Answer 3

1. Assessment
2. Engagement
3. ABC Model
4. Normalisation
5. Critical Collaborative Analysis
6. Developing Alternative Explanations

Question 4

Explain assessment.

Answer 4

Patient expresses thoughts about experiences & realistic goals discussed.

Question 5

Explain engagement.

Answer 5

Therapist empathises with patient’s perspective & feelings of distress that will be explored together.

Question 6

Explain the ABC model.

Answer 6

Patient gives explanation of the activating events that cause their beliefs & have consequences.
These beliefs can be rationalised & disputed.

Question 7

Explain normalisation.

Answer 7

Therapist provides info on prevalenve of unusual experiences to reduce patient anxiety of feeling isolated.
Place psychotic experiences on continuum with normal experiences so patient feels less stigmatised.

Question 8

Explain critical collaborative analysis.

Answer 8

Therapist asks questions to help patient understand illogical deductions.
“If the voices are real, why can’t others hear them?”
Atmosphere of trust is essential

Question 9

Explain developing alternative explanations.

Answer 9

Patient develops own alternative explanations for unhealthy assumptions.
New ideas constructed with therapist.