The Case Study Guide to Cognitive Behaviour Therapy of Psychosis

Many of us have attempted to do psychotherapy with psychotic patients and come away with the belief that it is difficult or impossible. As a result, these patients often receive medication but little in the way of psychotherapy. Years ago, during my psychology internship, I attempted to do group psychotherapy with psychotic patients, using Albert Ellis’s rational-emotive therapy approach. It seemed mostly unsuccessful—the patients seemed too disturbed to understand rational thinking principles. However, this book shows that successful psychotherapy with psychotic patients is possible.

The exciting finding is that the chapter authors, employing cognitive behavior therapy, successfully confront patients’ distorted thinking and get them to see things in a more rational, realistic way. I gather that the authors do not strongly confront every irrational thought but are selective and slowly but surely get the patients to see alternative ways of thinking about things. Thus, for example, paranoid delusions can change as the paranoid patient comes to see alternative ways of thinking about something.

The book has two major sections. The first, Case Studies, has 12 chapters, ranging from such topics as “Managing Voices” to “Tackling Drug-Related Psychosis and Isolation.” Part 2, Training, Supervision, and Implementation, consists of four chapters dealing with such things as “Training for CBT in Psychosis” and “Clinical Supervision.” All of the chapters are important and help us see how psychosis can be treated with cognitive behavior therapy. This book is highly recommended for those concerned with treating psychotic patients.