10 - Schizophrenia and psychotic disorders

Summary

Schizophrenia and psychotic disorders involve significant changes in a person's beliefs, perceptions, behaviors, and emotions. The focus of cognitive-behavioral therapy for psychosis (CBTp) in recent years has targeted the positive symptoms of psychosis. Systematic reviews of studies of CBTp with schizophrenia demonstrate moderate effect sizes, which suggest that CBTp is a useful intervention for schizophrenia-related illnesses. This chapter describes the treatment for individual CBTp and it can be delivered in a variety of settings, including inpatient and outpatient settings and in the patient's home, no matter what the patient's stage of illness. The risk of suicide in patients suffering from schizophrenia is significant and will likely be a problem clinicians encounter at some stage when working with psychotic patients. It does require considerable skill, experience, and knowledge of CBT and psychosis, and does not lend itself easily to simple protocol format.