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.)
This lecture provides an overview of CBT for Psychosis, and of this class.
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.
This video explores the breakdown of dialogue in psychosis, and the role of CBT in restoring both good external and internal dialogue.
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.
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.
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.
Doug Turkington demonstrates normalizing while working with a person struggling with voices.
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.
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.
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.
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."
Introduces a different attitude toward "hallucinations".....
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.
Most people with voices do best if they learn a variety of coping strategies. Some of the basic ones are outlined in this lecture.
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.
Watch an experienced CBT therapist, Dr Kingdon, explore a client's paranoia using CBT strategies.
What are delusions, from a CBT perspective? This lecture reviews some of the difficulties in defining delusions and some CBT approaches to those difficulties.
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.
This lecture covers some approaches to helping people who helping people who seem to be delusions without directly challenging the beliefs themselves.
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.
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.
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.
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.
Explore some possible purposes served by "negative symptoms" and then some CBT strategies for helping people overcome them.
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.
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.
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!
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.
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).