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Patients with severe mental illnesses can make substantial progress in reducing or eliminating distressing symptoms and can develop a much improved quality of life. Yet, most will have to contend with a risk for symptom worsening or relapse throughout their entire lives. Thus, CBT for severe mental illnesses needs to go beyond the typical courses of short-term treatment offered in uncomplicated cases of depression and anxiety disorders. In Chapter 8 (“Mania”), we introduced relapse prevention methods for bipolar disorder. We extend this discussion here by providing a basic framework for implementing CBT relapse prevention techniques across the range of severe mental illnesses. Suggestions are offered for helping patients use CBT skills to promote enduring treatment gains. We also discuss practical issues in designing long-term treatment plans and maintenance therapy regimens.
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