Therapy for Psychosis

Question 1

What is Psychosis?

Answer 1

• “Loss of contact with reality”
• Involves clusters of symptoms (positive & negative)

Question 2

Positive symptoms of Psychosis

Answer 2

Hallucinations, delusions

Question 3

Negative symptoms of Psychosis

Answer 3

Flat affect, avolition, lack of interest in social interactions

Question 4

When did psychological therapies for psychosis become widely investigated?

Answer 4

Not until the 1990s

Question 5

Why is there a lack of therapeutic optimism in treatment of schizophrenia?

Answer 5

• Poor results from early trials
• Neuroleptics seen as only viable treatment option

Question 6

5 Psychological therapies for psychosis

Answer 6

Rogerian/person - centred therapy

Psychoanalytic therapies

CBT (Cognitive Behaviour Therapy)

Family therapy

Interventions to reduce substance misuse

Question 7

NICE (2014) defines CBT for psychosis (CBTp) as an intervention where users….

Answer 7

• Establish links between thoughts, beliefs, perceptions and feelings in relation to their symptoms
• Re-evaluating these thoughts etc to target symptoms
• It should develop alternative ways of coping w symptoms and stress

Question 8

Basic CBTp strategies

Answer 8

Formulating (making sense)
Normalising
Improving coping

Question 9

What does formulating involve for CBTp

Answer 9

• Identifying thoughts, feelings & behaviours that are linked to symptom
• Show client how these interact to maintain the problem

Question 10

What is involved in normalising in CBTp

Answer 10

Challenging stigma of psychosis

Question 11

5 Myths about psychosis

Answer 11

1. People with psychosis are dangerous (theyre more likely to be victims of violence)
2. Psychosis is a diagnosis for life and there is no recovery
3. People with psychosis are unable to work
4. Psychosis always causes distress and people always need treatment
5. Psychosis is always a consequence of brain disease

Question 12

How many people have a single episode of psychosis that never occurs again?

Answer 12

30%

Question 13

How many people have persistent ongoing psychosis symptoms?

Answer 13

<25%

Question 14

What are some consequences of psychosis that aren’t brain disease?

Answer 14

Lack of sleep
Sensory deprivation
Substances or activities creating altered states of consciousness
Stressful events
Bereavement
Trauma

Question 15

How are coping strategies of psychosis experiencers enhanced?

Answer 15

Current strategies reviewed, seeing how often they’re used and how effective they are
Encouraged to experiment with new strategies

Question 16

Examples of coping strategies for psychosis

Answer 16

Humming, reading, singing, filling mouth with water
Dismissing the voice, responding rationally to voice content
Listen to soothing music, mindfulness meditation, positive imagery

Question 17

What therapy does NICE recommend for psychosis

Answer 17

CBT