CBTp

• What is CBTp?


  Cognitive Behavioural Therapy for Psychosis
• What is the central idea of CBTp?

  Patients' problems are based on incorrect beliefs and expectations
• What does CBTp aim to address?

  Underlying maladaptive thinking patterns associated with schizophrenia and changing patient's behavior
• What are some examples of irrational thinking that CBTp aims to alter?

  General beliefs, self-image, beliefs about what others think, expectations of how others will act, methods of coping with problems
• What is the purpose of CBTp?

  To make patients better able to cope with the symptoms of schizophrenia
• What is the expected outcome of CBTp?

  Improved ability to cope with symptoms and improved emotional attitudes
• What is the recommended number of sessions for CBTp?

  At least 16 sessions as recommended by NICE guidelines
• What are the stages of CBTp?

  Assessment, Engagement, ABC, normalisation, critical collaborative analysis and developing alternative explanations
• What is the goal of assessment in CBTp?

  To encourage the patient to explain their concerns, describe delusions, reflect on relationships, and lay out what they hope to achieve through therapy
• What is the goal of engagement in CBTp?

  To win the trust of the patient and establish a working relationship based on honesty, patience, and unconditional acceptance
• What does ABC stand for in CBTp?

  Antecedent, Behaviour, Consequences
• What is the purpose of understanding ABC in CBTp?

  To help the patient understand what is really happening in their life
• What is the antecedent?

  What triggers the patient's problem
• What is the behaviour?

  How the patient reacts in triggering situations
• What is the consequence?

  The impact of the patient's behavior on their relationships with others
• What is normalisation?


  Helping the patient understand that negative thoughts are normal.
• What does normalisation aim to reduce?

  Stress and shame about negative thoughts.
• What is critical collaborative analysis?

  Carrying on a logical discussion till the patient begins to see where their ideas are going wrong and why they developed
• What is the goal of critical collaborative analysis?

  Test faulty beliefs when they arise, and then challenge and re-think them
• What is the purpose of developing alternative explanations?

  Helping the patient find logical reasons for their troubles.
• What does developing alternative explanations involve?

  Finding coping strategies and logical reasons for troubles.
• Who conducted supporting evidence for CBTp?

  Jauhar et al. (2014)
• What did Jauhar et al. (2014) conduct?

  Meta-analysis of 34 studies into CBT.
• What did Jauhar et al. (2014) find?

  CBT has a significant but fairly small effect on both positive and negative symptoms.​
• What is the cost of CBT?


  Expensive
• Why is CBT expensive?

  Each therapist needs training and CBT itself requires one to one therapy sessions and 16 of these are recommended.
• Why is the high cost of CBT a problem?

  The NHS won't be able to offer CBT to as many patients​
• What are the ethics of CBT?

  CBT may involve challenging paranoia, but at what point does that interfere with their freedom of thought? For example, their politics could be modified. ​
• Does CBT treat positive symptoms, negative symptoms or both?


  Both
• What are issues with use of CBT with patients?

  Hard to engage with: CBT requires motivation to attend all sessions and engage with the content. ​