Cognitive-behavioral therapy of psychosis (CBTp) is a structured intervention to address the symptoms of serious mental illness including anhedonia, anxiety, delusions, depression, hallucinations, mania, hypomania, negative symptoms, sleep difficulties, and hopelessness. It can also target areas such as interpersonal problems, isolation, motivation, social skills, self-esteem, and medication adherence. Similar to Cognitive-Behavioral Therapy (CBT) for other types of problems, CBTp involves establishing a collaborative therapeutic relationship, developing a shared understanding of the problem, setting goals, and teaching the person techniques or strategies to reduce or manage their symptoms. Therapy is usually conducted in individual sessions and is time-limited (typically several months). Patients learn specific cognitive and behavioral coping strategies in order to reduce distress and improve functioning. The goal is to reduce the distress the patients experience in their daily life. Specific CBTp approaches include cognitive restructuring, behavioral experiments/reality testing, self-monitoring and coping skills training. Unique considerations in treating psychosis include emphases on being non-confrontational and on normalizing psychotic experiences insomuch as they are on a continuum with non-psychotic experiences. CBTp can focus specifically on psychotic symptoms (i.e., hallucinations or delusional beliefs) but has also been shown to be helpful for addressing depression and/or anxiety associated with psychotic symptoms and their impact on the person’s life.
SMI Adviser provides an excellent webinar on understanding the basics of CBT for psychosis.