CBTp

• What is CBTp?

  • A form of therapy to help patients identify irrational thoughts and challenge them (including the origin of ‘voices’) and reality testing to reduce distress
  • It uses the ABCDE model
• Features of CBTp

  • Critical collaborative analysis, therapist uses gentle questioning to help patient understand and challenge illogical deductions
  • Normalisation, therapist shares with patient that many people have unusual experiences
• Limitation with small scale studies on CBTp efficacy

  • Lack of a control group or random allocation when assessing CBTp efficacy
  • Likely CBTp is more effective for some sufferers more than others due to individual differences
  • Difficult to conclude that the improvement found is due to the therapy and not other factors- such as spontaneous recover
  •  No random allocation = people with less severe symptoms may be placed in the treatment group, more likely to show an improvement than people with more severe symptoms
• Limitation of CBTp not a cure (AO3)

  • CBTp only aims to make schizophrenia more manageable and improve the patients’ quality of life
  • Allows patients to make sense of and challenge some of their symptoms through critical collaborative analysis
  • Should not be confused with curing schizophrenia.
  • Therefore, whilst CBTp may provide patients with strategies that they can use to manage their current and future symptoms, it does not effectively cure schizophrenia.
• CBTp is difficult to access (AO3)


  • Despite being recommended by NICE as a treatment for people with schizophrenia, it is estimated that only 1 in 10 people in the UK who could benefit from CBTp can get access to it
  • Haddock et al. (2013) found that in NW England, only 6.9% of patients had been offered CBTp
• CBTp efficacy support (AO3)

  • The NICE review of treatments for schizophrenia (NICE, 2014) found consistent evidence that when compared with standard care (antipsychotics alone)
  • CBTp was effective in reduction rehospitalisation rates up to 18 months following the end of treatment
  • CBTp was also shown to be effective in reducing symptom severity and improving social functioning
  • Suggests CBTp is effective in improving QOL
  • However, most studies of the effectiveness of CBTp have been conducted with patients treated at the same time with antipsychotic medication. It is therefore difficult to assess the effectiveness of CBTp independent of antipsychotics
• CBTp LIMITED EFFFICACY/APPROPRIACY (AO3)

  • CBTp may be more effective at certain stages of the disorder
  • Addington and Addington (2005) claim that self-reflection is not particularly appropriate during the initial acute phase of schizophrenia
  • Following stabilisation of the psychotic symptoms with antipsychotics, individuals may then benefit more from group-based CBTp
  • This can help to normalise their experience by meeting others with similar issues
  • Research has found that it is those with more experience of their schizophrenia and a greater realisation of their symptoms that benefit more from individual CBTp
  • This suggests that CBTp is effective, but may be more appropriate in the latter stages of treatment rather than initially.