CBT for Psychosis

An Individualized, Recovery Oriented Approach
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  • Lectures 36
  • Length 11.5 hours
  • Skill Level Beginner Level
  • Languages English
  • Includes Lifetime access
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About This Course

Published 6/2015 English

Course Description

Cognitive Behavioral Therapy (CBT) for psychosis is an evidence-based method to reduce distress and disability related to psychotic experiences, and to support a possible full recovery. Psychotic experiences are conceptualized as being understandable in relationship to an individual's life story, and capable of being altered when people experiment with different ways of thinking and behaving. Learn how to collaborate with people having these experiences, “exploring the evidence" rather than imposing beliefs, and developing coping options so people are not forced to rely entirely on the often limited effectiveness of medication to address problems.

The course starts by examining the nature of psychosis and CBT, providing a foundation for understanding how CBT can be helpful. Then the basic style of CBT for psychosis is introduced, followed by an introduction to two of the most important techniques. Finally, applications of CBT are explored for some of the main problem areas, such as hearing distressing voices, paranoia, delusional beliefs, disorganization, and negative symptoms.

Included in the course are video lectures, slides with some diagrams, video demonstrations of CBT for psychosis being practiced, and links to additional resources for further study.

CBT for psychosis uses a minimal amount of jargon, and the concepts and practices tend to be easily understandable.

The course will take 5 hours to complete.

5 hours of continuing education credits are available for social workers, psychologists, and nurses in the US, and also for licensed professional counselors and marriage and family therapists is some states in the US. (See the “What am I going to get from taking this course" section for more details on those.)

What are the requirements?

  • This course will make more sense to those who are trained in providing therapy, and especially CBT therapy, but will also be mostly understandable to a much broader audience.

What am I going to get from this course?

  • Use evidence-based CBT approaches to reduce distress and disability related to psychotic experiences.
  • Normalize psychotic experiences by seeing them as understandable in relationship to an individual’s life story, and capable of being altered when people experiment with different ways of thinking and behaving
  • Develop formulations that promote hope and provide direction for treatment and recovery
  • Utilize a collaborative style to engage in guided discovery of solutions to distressing psychosis-related problems, including those which have resisted the often limited effects of medications
  • Explore ways of integrating this psychological approach with existing treatment methods
  • Continuing Education credit for this program is awarded by Commonwealth Educational Seminars (CES) for the following professions:
  • Psychologists: Commonwealth Educational Seminars (CES) is approved by the American Psychological Association (APA) to offer continuing education credit programs. CES maintains responsibility for this program and its content. Psychologists receive 5 hours of continuing education credit upon completing this program.
  • Marriage and Family Therapists: Continuing education credit for Marriage & Family Therapists is awarded in the following states: AL, AR, AZ, CA, CO, CT, DC, DE, FL, GA, HI, ID, IN, IA, KS, ME, MD, MO, MT, NE, NH, NJ, NM, NC, OR, PA, RI, SC, SD, TN, TX, VT, VA, WA, WI, WY. CES maintains responsibility for this program. Marriage and Family therapists completing this program will receive 5 CE hours of credit.
  • Social Workers: CES, provider #1117, is approved as a Provider for Social Work Continuing Education by the Association of Social Work Boards (ASWB) www.aswb.org, through the Approved Continuing Education (ACE) program. CES maintains responsibility for the program. ASWB Approval Period: October 15, 2015 through October 15, 2018. Social Workers should contact their regulatory board to determine course approval. Social Workers completing this course will receive 5 clinical continuing education clock hours.
  • Licensed Professional Counselors/Licensed Mental Health Counselors: CES is entitled to award continuing education credit to LPCs/LMHCs in the following states: AZ, AR, CA, CO, CT, DE, FL, GA, HI, ID, IL, IN, IA, KS, KY, ME, MA, MO, NE, NH, NJ, NM, NC, OR, PA, RI, SC, SD, TN, VT, VA, WA, WI, WY. CES maintains responsibility for this program. LPC/LMHCs completing this program will receive 5 continuing education hours of credit.
  • Nurses: As an American Psychological Association approved provider CES programs are accepted by the American Nurses Credentialing Center (ANCC). Every state Board of Nursing accepts ANCC approved programs except California and Iowa. CES maintains responsibility for this program. Nurses completing this program receive 5 hours of continuing education credit.

What is the target audience?

  • This course is intended for people who provide mental health treatment for people diagnosed with various kinds of psychotic disorders. It is intended as an introductory course, aimed at getting people started in using these methods. To become fully proficient at providing CBT for psychosis would of course require substantially more training.
  • This course may also be of some interest to people who have had some psychotic experiences and to their family members, but it is not designed for them specifically and it definitely is not intended to provide any kind of individual or family therapy.

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Curriculum

Section 1: Introduction: What is CBT for Psychosis, How is It Different?
05:31

This lecture provides an overview of CBT for Psychosis, and of this class.

11:25

This lecture discusses the use of CBT for Psychosis with people both on antipsychotic medications and off, discusses some ideas about the relationship between medications and long term recovery, and offers some contrasts between the perspective of CBT for Psychosis and that of a purely bio-medical model.

What is Psychosis?
Preview
04:18
12:12

This video explores the breakdown of dialogue in psychosis, and the role of CBT in restoring both good external and internal dialogue.

Section 2: Essentials of the style of CBT for Psychosis
10:20

This lecture covers two very fundamental aspects of any successful therapy for psychosis; the establishment of a good collaborative relationship, and the promotion of reasonable levels of hope.

Other essentials of the CBT for Psychosis approach
16:13
Section 3: Normalizing: A way to reduce fear, and increase hope and successful coping
What normalizing is, what it's good for
Preview
12:35
11:51

Understanding psychotic experience as being on a continuum with other human responses is very helpful within normalizing explanations: this lecture will help you understand and use this perspective.

15:02

Depending on the language used, our clients may learn how to normalize their experiences and so feel more in control and related to other human beings, or may learn to "abnormalize" their experience in a way that increases distress and alienation. This lecture will increase your understanding of how to use language to promote normalizing.

1 page

Doug Turkington demonstrates normalizing while working with a person struggling with voices.

06:43

This lecture uses a powerful example to illustrate the role of a normalizing explanation in helping someone shift from a vicious circle of increasing distress to a virtuous circle of increased self understanding and self care.

Section 4: Developing a Formulation - Finding Hope and Direction
08:54

This lecture provides some perspective on how CBT therapists address psychosis differently than what has been traditional within the mental health system, where a hypothesized "illness" has usually been conceptualized as explaining a wide number of symptoms, and where biological problems have usually been conceptualized as primary.

A wider way of understanding "bio-psycho-social" and "stress-vulnerability" is discussed, and the use of those wider understandings within formulations.

12:06

Varieties of formulations examined in this lecture include an ABC formulation, a variation of the 4 areas "kite" diagram, a spiral formulation, and a more in depth compassion focused formulation. How to use each of these types of formulation in order to nurture hope and provide direction fro recovery efforts will be explored.

11:19

A developmental formulation traces how developmental issues and related issues contribute to psychotic experience. In this lecture, a personal story of somewhat psychotic experience and then recovery will be told, with some discussion of how things might have gone differently had certain factors been other than they were. This is followed by a more general exploration of how to help people escape both a "psychotic story" and a "psychiatric story" so as to hopefully come back to an "evolving human story."

Section 5: Helping Solve Problems With Voices, Visions, Etc.
1 page

Introduces a different attitude toward "hallucinations".....

11:54

This lecture explores some of the problems that can arise when efforts are focused too much on the suppression of voices and other "hallucinations," and then outlines a different approach based on a combination of limit setting with acceptance.

The continuum of thoughts, dissociative experience and voice hearing
09:37
17:02

Most people with voices do best if they learn a variety of coping strategies. Some of the basic ones are outlined in this lecture.

1 page
Some people may find that hearing voices groups go well alongside CBT, while others may find these groups may be the primary support they need in working toward recovery! Learn a bit more about that.....
Section 6: Strategies for paranoia and troublesome beliefs
14:24

How do CBT therapists understand paranoia, and how do they work with it? Learn strategies to talk about paranoia in a helpful way and to explore it further.

1 page

Watch an experienced CBT therapist, Dr Kingdon, explore a client's paranoia using CBT strategies.

07:31

What are delusions, from a CBT perspective? This lecture reviews some of the difficulties in defining delusions and some CBT approaches to those difficulties.

02:54

How do CBT therapists work with people who seem to be delusional? This lecture outlines four different strategies that may be used at different times.

14:54

This lecture covers some approaches to helping people who helping people who seem to be delusions without directly challenging the beliefs themselves.

1 page

In this video, a person with an entrenched belief is interviewed by a CBT therapist to discover what preceded that belief, and to obtain the story of how it developed.

16:03

When a person is ready for it, exploring the evidence both for and against the belief can be helpful. This video will give you ideas about how to do that.

1 page

Watch an experienced CBT therapist help a client develop a plan for carrying out a test that might support or fail to support a particular belief.

Section 7: When thoughts are out of order, & affect and engagement seem missing...
08:38

This lecture addresses both possible understandings of what is going on within "thought disorder" as well as strategies for working with people who are thinking and talking in this way.

11:10

Explore some possible purposes served by "negative symptoms" and then some CBT strategies for helping people overcome them.

Section 8: Wrapping things up
07:06

Learn how to help people develop an individualized relapse prevention plan, which includes ideas about how to respond to, but not over-react to, the return of various kinds of problematic experiences.

10:47

Now that you know something about CBT for psychosis, how will you fit it into what you and perhaps your agency are already doing? This lecture will give you some ideas about how to do that, as well as outline some areas for future progress.

09:47

Homework is a key part of CBT, including CBT for Psychosis. Learn how to structure it into every session.

Also, it's time to think about your own "homework" as you develop your plan to put the ideas you learned in this course to work!

02:34

While this course can get you started with CBT for Psychosis, you can anticipate requiring further training in order to be a proficient practitioner. This lecture will give you some ideas about where to look to seek such training.

The Document that Lists Ways to Learn More about CBT for Psychosis
2 pages
To Download the PowerPoint Slides
Article
Section 9: Getting your CE Credits
Instructions for accessing and taking the test
1 page

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Instructor Biography

Ron Unger, Licensed Clinical Social Worker

Ron Unger is a therapist with 13 years experience specializing in Cognitive Behavioral Therapy (CBT) for Psychosis, and an educator with extensive experience teaching continuing education seminars on that and on related topics. He serves as adjunct faculty at Portland State University, and teaches regularly at JFK University in Berkeley CA as well. He is also chairperson of the education committee for the US Chapter of the International Society for Psychological and Social Approaches for Psychosis (ISPS).

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