What Is CBT For Psychosis?
If you or a loved one are experiencing psychosis, someone may suggest that you try a type of psychotherapy called Cognitive-Behavioural Therapy for psychosis (CBTp). Here’s an introduction to CBTp to help you decide if it might be right for you.
What is CBTp?
CBT for psychosis (CBTp) is a type of psychotherapy that adapts traditional CBT (e.g., for anxiety disorders, depression, etc.) and applies it with folks experiencing psychosis. Like traditional CBT, CBTp works to identify unhelpful thought and behaviour patterns and provides strategies to help clients feel more satisfied and be more productively-engaged in their lives. The primary adaptations in CBTp generally pertain to the types of thoughts and behaviours that are focused on, like challenging paranoid or grandiose delusions or helping accept distressing hallucinations.
There is a misconception that folks with psychosis can’t benefit from psychotherapy. This is not true. CBTp has considerable research evidence behind it to show that it is helpful for many of the clients who try it.
What can you expect in CBTp?
Not every course of CBTp will be the same, but here are some things you can expect to encounter if you decide to try CBTp:
You’ll have an initial assessment with your therapist. This will likely take at least an hour or two, and the therapist will ask you a series of questions about your current life and symptoms/difficulties, therapy and life goals, and your experiences growing up. You may also be asked to fill out questionnaires. The therapist will then provide you with a formulation of your difficulties and a treatment plan.
You’ll probably be asked to track your thinking patterns and symptoms. Your therapist may suggest that you keep a record of your distressing thoughts and hallucinations for a few weeks to help both of you get a better sense of your issues.
Once you and your therapist have a clearer sense of your difficulties and what increases and decreases your distress, your therapist will teach you skills to help manage your stress. We describe a few of these skills in more detail below.
You’ll likely have discussions related to relapse prevention. This is a process in which you identify some of the triggers for and warning signs of unwellness, and then generate ideas for ways to reduce the likelihood of an episode happening at all, or at least decrease the difficulties that arise if you do have another episode.
What are examples of helpful CBTp skills?
Here’s is a basic list of some of the general CBTp skills you might learn in therapy:
Relaxation strategies like deep breathing, grounding, and progressive muscle relaxation
Mindfulness strategies, including formal meditation practices and informal mindful focusing on daily activities
Cognitive (thought) reframing strategies that will help you identify unhelpful thinking patterns and work to change them into more balanced, helpful thoughts
Short-term distraction exercises to help you navigate distressing beliefs and hallucinations. Note that the emphasis here is on short-term distraction because constantly attempting to distract ourselves is often an unhelpful long-term strategy
Behavioural experiments, which are ways in which you can test out some of your difficult thoughts to see how helpful and accurate they actually are
These are some of the elements and skills you can expect to encounter if you decide to begin a course of CBTp with a trained professional. Know that you are not alone and can get help for your difficulties!
WG Psychology
WG Psychology is a psychology and psychotherapy clinic based in Toronto that helps people live more connected, purposeful lives through compassionate, evidence-based mental health support. Connect with us to see if we’re a fit for you!
Disclaimer: This post is intended for educational purposes only and is not a substitute for psychotherapy. The information provided is general and may not be appropriate for your particular mental health needs. Always consult a qualified health professional to discuss your personal needs and goals.