Lecture 4, Psychosis Flashcards
Cognitive Behavior Therapy (CBT)
CBT is a form of psychotherapy that focuses on the relationship between thoughts, feelings and behaviors. It is based on the idea that negative or distorted thoughts can lead to negative emotions and behaviors. CBT aims to help individuals identify and change these negative thought patterns to improve their emotional and behavioral functioning.
CBT is typically short-term, with sessions lasting between 30 minutes to an hour. It is usually structured, with specific goals and objectives identified at the beginning of therapy. The therapist and client work together to identify negative thought patterns and behaviors, and develop strategies to challenge and change them.
Formulating (Making Sense) - A basic CBT strategy
The therapist works with the client to identify the thoughts, feelings, and behaviors that are linked to the problem/symptom targeted. They help the client to see how these interact to maintain the problem in the present, and create a shared understanding of how the problem developed and what could be done to resolve it
Normalizing Psychosis - Basic CBT strategy
This involves challenging the stigma of psychosis and correcting common misconceptions about it. The aim is to provide accurate information and promote accurate views about psychosis. Psychoeducation is also provided to help individuals learn about and understand mental health.
Developing Coping Strategies
CBT involves developing alternative ways of coping with the target symptoms, and/or reduction of distress, and/or improvement of functioning. This may involve developing new behavioral strategies, such as problem-solving and relaxation techniques, or challenging negative thought patterns through cognitive restructuring.
Overall, CBT is a highly effective form of therapy that has been shown to be effective for a wide range of mental health problems.
Coping Strategies for Psychosis:
Understanding Psychosis: Inner speech and auditory verbal hallucinations
Responding Differently to Symptoms
Reduce Arousal and Distress
Strategies to Change Unhelpful Thoughts, Beliefs, and Appraisals:
Negative beliefs about psychosis can lead to distress and impairment
CBT therapists can use a range of strategies to change these beliefs:
Socratic questioning in session
Asking clients to keep a log of recent voice hearing experiences
Behavioural experiment
Evidence/counterevidence analysis
Effectiveness of CBT for Psychosis:
Over 50 RCTs have examined the efficacy of CBT in people with psychosis
Positive findings across most “stages” of psychosis, including:
First episode psychosis/early psychosis
Acute psychosis
People at risk of relapse
Treatment resistant psychosis
Groups
CBTp can be effective on its own, even in individuals that are not taking antipsychotic medication
NICE recommends that CBT should be offered as a first-line treatment across the continuum of psychosis
People at clinical high risk (prodrom)
First episode psychosis
“Chronic psychosis” to promote recovery
Considering Trauma in Psychosis:
NICE recommends that all people with psychosis should be assessed for trauma and post-traumatic stress
Trauma-focused psychological therapies (including CBT) should be offered when appropriate
More research is needed to determine their safety and efficacy in this specific population.
Summary of CBTp
Psychosis symptoms can lead to distress and reduction in functioning for some people
CBTp is effective and recommended as a first line of treatment for psychosis by NICE
Appraisals of events, not the events themselves, determine behaviours, thoughts, feelings, and distress.
Psychoeducation:
Learning about and understanding mental health (e.g., providing reading material/information about psychosis).
