The Program
Cognitive Behavioral Therapy for psychosis (CBTp) is a structured, short-term therapy designed to help individuals experiencing psychosis or similar symptoms. It focuses on personal recovery goals and works with clients to address thoughts, feelings, and behaviors that interfere with these goals. By treating psychotic experiences as understandable and manageable, CBTp aims to reduce distress and foster personal agency in recovery.
Intended Audience
This program is helpful for individuals who are at high risk of developing psychosis within an early phase of a psychotic disorder, or at later stages. In some cases, individuals who experience medication-resistant psychosis also benefit from this intervention.
Implementation
CBTp is recommended for use across various settings, including mental health systems, primary care, correctional facilities, forensic environments, and educational institutions. It is typically delivered through weekly 50-minute sessions over 25 weeks, though shorter symptom-specific protocols are also effective. CBTp can be provided in-person, via telehealth, and through smartphone apps, though only a few digital options have been empirically tested. Implementing CBTp requires resources tailored to the setting, such as trained mental health professionals and a stepped care model for larger organizations. Successful integration involves attention to referral pathways, treatment assessment, reimbursement, and care coordination, along with a recovery-oriented approach that prioritizes client empowerment and family involvement. Adequate training and supervision for therapists are crucial for effective delivery.
Outcomes
- CBTp helps alleviate psychotic and mood symptoms
- It reduces the risk or duration of hospitalization
- CBTp improves consistency with medication use
- Treatment benefits often persist after therapy ends
- Effect sizes for CBTp on delusions and hallucinations are like antipsychotic medications
- CBTp should be used alongside medication
- It is best implemented within a multidisciplinary care approach
Evidence
CBTp has over 30 years of empirical support, showing its effectiveness across different stages of illness, care settings, therapeutic approaches, specific symptoms, and diverse populations. Research consistently indicates that CBTp helps individuals manage psychotic symptoms such as hallucinations, delusions, and negative symptoms related to motivation and emotional expression. Additionally, it offers relief from depression and anxiety, improves sleep and daily routines, and promotes regular medication adherence.
Additional Resources