Cognitive behaviour therapy for psychosis

2018 ◽  
Author(s):  
Majella Byrne ◽  
Suzanne Jolley ◽  
Emmanuelle Peters
Keyword(s):  
Cognitive Behaviour Therapy ◽  
Current Evidence ◽  
Psychotic Symptoms ◽  
Positive Symptoms ◽  
Psychological Processes ◽  
Behaviour Therapy ◽  
New Developments ◽  
Effective Implementation ◽  
Cognitive Behaviour ◽  
Positive Symptoms Of Psychosis

This chapter outlines current cognitive behaviour therapy approaches for positive psychotic symptoms and their theoretical underpinnings. The difficulties of translating research into frontline practice are examined, with recommendations for effective implementation. Evidence for the effectiveness of cognitive behaviour therapy for psychosis (CBTp) is reviewed, identifying challenges in the design, conduct, and interpretation of evaluations. New developments are highlighted, including specific interventions designed to target single psychological processes hypothesized to cause or maintain distressing psychotic symptoms. The current evidence for CBTp specifically for those with persisting and distressing positive symptoms of psychosis, who either do not respond to medication or have chosen not to take medication, is outlined. Finally, predictors of good outcome in CBTp are presented.

ARE SOME TYPES OF PSYCHOTIC SYMPTOMS MORE RESPONSIVE TO COGNITIVE-BEHAVIOUR THERAPY?

2001 ◽  
Vol 29 (1) ◽  
pp. 45-55 ◽  
Author(s):  
Nicholas Tarrier ◽  
Caroline Kinney ◽  
Ellis McCarthy ◽  
Anja Wittkowski ◽  
Lawrence Yusupoff ◽  
...  
Keyword(s):  
Cognitive Behaviour Therapy ◽  
Negative Symptoms ◽  
Controlled Trial ◽  
Chronic Schizophrenia ◽  
Routine Care ◽  
Psychotic Symptoms ◽  
Positive Symptoms ◽  
Behaviour Therapy ◽  
Cognitive Behaviour ◽  
Supportive Counselling

Results are presented from a randomized controlled trial indicating which psychotic symptoms respond to cognitive behaviour therapy. The aim of the study was to investigate whether different types of psychotic symptoms are more or less responsive to cognitive-behaviour therapy compared to treatment received by control groups. Seventy-two patients suffering from chronic schizophrenia who experienced persistent positive psychotic symptoms were assessed at baseline and randomized to either cognitive-behaviour therapy and routine care, supportive counselling and routine care, or routine care alone and were re-assessed after 3 months of treatment (post-treatment). Independent and blind assessment of outcome indicated delusions significantly improved with both cognitive behaviour therapy and supportive counselling compared to routine care. Hallucinations significantly decreased with cognitive-behaviour therapy compared to supportive counselling. There was no difference in the percentage change of hallucinations compared to delusions in patients treated by cognitive behaviour therapy. There was little change in measures of affective symptoms but there was no evidence that a reduction in positive symptoms was associated with an increase in depres sion. In fact, a reduction in positive symptoms was positively correlated with a reduction in depression. There were significant differences in the reductions in thought disorder and negative symptoms with an advantage of cognitive-behaviour therapy compared to routine care.

Developments in Cognitive-Behaviour Therapy for Persistent Psychotic Symptoms

1994 ◽  
Vol 11 (4) ◽  
pp. 200-212 ◽  
Author(s):  
Gillian Haddock ◽  
William Sellwood ◽  
Nicholas Tarrier ◽  
Lawrence Yusupoff
Keyword(s):  
Cognitive Behaviour Therapy ◽  
Auditory Hallucination ◽  
Psychotic Symptoms ◽  
Positive Symptoms ◽  
Behaviour Therapy ◽  
Behavioural Treatment ◽  
Psychological Treatments ◽  
Cognitive Behavioural Treatment ◽  
Cognitive Behavioural ◽  
Cognitive Behaviour

This paper is a review of studies on psychological treatments for positive psychotic symptoms, and a detailed description of two of these studies, the Manchester Symptom Project, which aimed to decrease positive symptoms by training patients in effective coping strategies, and the Liverpool Auditory Hallucination project, which aimed to provide a cognitive-behavioural treatment for individuals with persistent and distressing voices. The results from these studies indicate that enduring positive symptoms which have not responded to neuroleptic medication can be effectively treated by psychological methods.

Preliminary Evaluation of Culturally Adapted CBT for Psychosis (CA-CBTp): Findings from Developing Culturally-Sensitive CBT Project (DCCP)

2014 ◽  
Vol 43 (2) ◽  
pp. 200-208 ◽  
Author(s):  
Nazish Habib ◽  
Saima Dawood ◽  
David Kingdon ◽  
Farooq Naeem
Keyword(s):  
Cognitive Behaviour Therapy ◽  
Negative Symptoms ◽  
Rating Scales ◽  
Controlled Trial ◽  
Psychotic Symptoms ◽  
Western World ◽  
Preliminary Evaluation ◽  
Behaviour Therapy ◽  
Culturally Adapted ◽  
Cognitive Behaviour

Background: Cognitive Behaviour Therapy for Psychosis (CBTp) has a strong evidence base and is practised widely in the Western World. Psycho-social interventions, on the other hand, including Cognitive Behaviour Therapy (CBT) are hardly used in the low and middle income countries for psychosis. It has been suggested that adaptations in content, format and delivery are needed before CBT can be used outside the Western cultures. We describe preliminary evaluation of Culturally Adapted Cognitive Behaviour Therapy for Psychosis (CaCBTp) in in-patient settings in Lahore, Pakistan. Aims: We aimed to evaluate the efficacy of culturally adapted CBT for psychosis (CaCBTp) in Pakistan in a pilot project. Method: In a randomized controlled trial we tested CaCBTp against treatment as usual (TAU) in in-patient settings in Pakistan. Those diagnosed with schizophrenia according to the DSM-IV-TR, and who fulfilled the inclusion criteria, were recruited into the study. Patients (n = 42) were randomized into two equal groups, i.e. CaCBTp and TAU. Assessments were carried out both at the baseline and then at the end of the therapy by raters blind to the groupings. Psychopathology was measured using PANSS (Positive and Negative Syndrome Scale of Schizophrenia), PSYRATS (Psychotic Symptom Rating Scales), and the Insight Scale. Results: Patients receiving CaCBTp showed statistically significant improvement on measures of positive symptoms (p = .000), negative symptoms (p = .000), overall psychotic symptoms (p = .000), hallucinations (p = .000), delusions (p = .000) and insight (p = .000) at the end of the therapy. Conclusions: The CaCBTp was effective in reducing symptoms of psychosis and in improving insight in in-inpatient settings in Pakistan.

Cognitive behaviour therapy for psychosis

2006 ◽  
Vol 15 (4) ◽  
pp. 267-275 ◽  
Author(s):  
Elizabeth Kuipers ◽  
Paul Bebbington
Keyword(s):  
Empirical Studies ◽  
Cognitive Model ◽  
Positive Symptoms ◽  
Behaviour Therapy ◽  
Cognitive Behavioural ◽  
Social Adversity ◽  
Cognitive Behaviour ◽  
Positive Symptoms Of Psychosis ◽  
Reasoning Biases

SummaryAims – It used to be thought that the problems of psychosis were qualitatively difference from those of other disorders and therefore unamenable to psychological interventions. However more recent evidence will be summarised which suggests otherwise. Methods – A cognitive model of the positive symptoms of psychosis (Garety et al, 2001; Kuipers et al.,2006) is described which builds on work on the dimensions of symptoms of psychosis, the continuum between non-clinical and clinical populations, and the contribution of emotional processes, cognitive reasoning biases and social factors. Results – Evidence from both epidemiological and empirical studies from our research group and others, support some of the pathways of symptom formation and maintenance proposed by the model. Specifically there is evidence for the role of trauma, social adversity and stress. These may trigger emotional responses and unusual experiences and together with reasoning biases lead to appraisals that can be defined as positive symptoms such as delusions and hallucinations. Similar processes interact to maintain symptoms. Conclusions – Cognitive models of psychosis have led to the development of cognitive behavioural treatments for delusions and hallucinations, which show some evidence of efficacy. Such treatments need to be refined in the light of recent research.Declaration of Interest: none

Cognitive behaviour therapy for schizophrenia

2012 ◽  
pp. 1313-1317
Author(s):  
Max Birchwood ◽  
Elizabeth Spencer
Keyword(s):  
Cognitive Behaviour Therapy ◽  
Medication Compliance ◽  
Psychotic Symptoms ◽  
Behaviour Therapy ◽  
The Core ◽  
Cognitive Behaviour ◽  
Psychosocial Approaches

Cognitive behaviour therapy (CBT) for schizophrenia focuses on the core psychotic symptoms of hallucinations and delusions. Other psychosocial approaches to psychosis (e.g. intervention with families and to promote medication compliance) also frequently use CBT techniques. In this chapter, however, we focus on CBT for delusional beliefs and other psychotic phenomena and review evidence for its efficacy.

North Wales randomized controlled trial of cognitive behaviour therapy for acute schizophrenia spectrum disorders: two-year follow-up and economic evaluation

2005 ◽  
Vol 35 (9) ◽  
pp. 1307-1316 ◽  
Author(s):  
MIKE STARTUP ◽  
MIKE C. JACKSON ◽  
KEITH E. EVANS ◽  
SUE BENDIX
Keyword(s):  
Social Functioning ◽  
Cognitive Behaviour Therapy ◽  
Standard Care ◽  
Direct Costs ◽  
Index Admission ◽  
Control Group ◽  
Positive Symptoms ◽  
Behaviour Therapy ◽  
Acute Schizophrenia ◽  
Cognitive Behaviour

Background. There is good evidence now that cognitive behaviour therapy (CBT) is effective in the treatment of people suffering from schizophrenia. There is also some evidence that the benefits of CBT persist after the end of treatment and that the direct costs of providing CBT as an adjunct to standard care are no higher than the direct costs of standard care alone. The aims of the present study were to discover if the benefits of CBT for acute schizophrenia which were found 1 year after index admission persist for another year, and to evaluate the comparative costs of providing CBT.Method. Consecutive admissions meeting criteria were recruited. After screening, 43 were assigned at random to a treatment-as-usual (TAU) control group and 47 were assigned to TAU plus CBT. Patients (73% of original) were rated on symptoms and social functioning 2 years after index admission. An evaluation of the direct costs of services was also completed.Results. The CBT group had maintained its advantage over the TAU group on negative symptoms and social functioning but had lost the advantage it previously enjoyed in positive symptoms. The difference between groups in total direct costs over the 2 years was not statistically significant despite the cost of providing CBT.Conclusions. Some of the benefits of CBT for patients suffering acute psychotic episodes persist for 2 years. After the end of regular treatment, CBT should probably be targeted on the appearance of early signs of relapse to forestall the re-emergence of positive symptoms.

A critical evaluation of the role of cognitive behaviour therapy in children and adolescents with depression

2009 ◽  
Vol 2 (2) ◽  
pp. 83-91 ◽  
Author(s):  
Maura Delaney
Keyword(s):  
Children And Adolescents ◽  
Cognitive Behaviour Therapy ◽  
Depressive Disorders ◽  
Critical Evaluation ◽  
Evidence Base ◽  
Current Evidence ◽  
Behaviour Therapy ◽  
Treatment Of Depression ◽  
Cognitive Behaviour ◽  
Current Evidence Base

AbstractDepressive disorders are relatively common in adolescents although less so in younger children. They accrue significant morbidity and frequent long-term sequelae as well as increased suicide risk in sufferers. Evidence-based treatment of depression in children and adolescents is the subject of intense investigation and debate. This article reviews the current evidence base for cognitive behaviour therapy in this group and makes recommendations for further areas of research.

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