What is CBT for psychosis anyway?


There has been much heated debate in recent weeks about whether cognitive behavioural therapy for psychosis has been totally over-egged. One stance is that Nice (the National Institute for Clinical Excellence) has recommended a treatment with little or no evidence base. Another is that CBT is a helpful intervention for many people experiencing psychotic-like phenomena.

But what is CBT for psychosis? What does it look like? And how can knowing this help us to understand the issues being argued about?

Psychosis is an umbrella term for a collection of symptoms. These symptoms get classed as “positive” or “negative”, which is not to infer that some are good and some are bad, but rather to capture the fact that some of the symptoms add something new and others take something away. Positive symptoms are those that add an unusual experience of some kind, eg seeing things that others can’t (hallucinations) or strongly believing things that don’t make sense to others (delusions). Negative symptoms involve something being taken away from the person, eg a lack of enjoyment (anhedonia), motivation (avolition), or a lack of emotion.

Whilst a recent meta-analysis has shown only limited evidence for the effectiveness of CBT for psychosis and suggested that previous results are inflated, we should be cautious about using this one meta-analysis to chuck out CBT for psychosis. Among other potential holes that could be poked in its conclusions is the fact that the analysis uses psychotic symptoms as the only outcome measure for effectiveness, which might not be the best or only thing we should be looking at.



If the existential features of the things so-called psychosis
is unknown for who working on CBT,then do not wait achieve
any understanding to the issue of sz

the researchers have wrong basic information
about the essential nature of the things that so-called psychosis,
thereby all their conclusions are fatal mistakes ,and CBT does
not led to real treatment or led to understand the reality of psychosis or else

what is the pure evidence ?
look at the randoum definition of the psychosis,
and look at the primitive classification "positive /negative }
they have not any actual knowing with the basic
nature of the things so-called psychosis !
1- manilly,the basic symptom of sz case,is the sums of
the new things which has been located inside the basic nature
of the individual
2- inside the main nature of the schizophrenic individual,
there is no a whole case called sz,but there is a new group
of vibrant existential features
1- the existential features is not symptoms in its nature
-it is not organic symptoms,but it is similar to the mind-psychic
characteristics of the human being
-they are higher organism
-they are a whole entities, not a symptoms of disease or illness
-they can produce the voice and making all higher mental functions
more than the ability of the human being
-they are look like a psychological entities that
have not biological body like the human being
-they are psychological entities free from biological body or life,
i.e they are psychological life without having biological life
-you can consider them as they are a human being without body,
thereby they can do all psychological/mental and emotional functions like the human being
but they can not produce the outputs behaviors {expressive or kinetic }
=these entities have act and behave inside mind-brain of the host
like you have act and behave internally
-they make up a case of existential overlap inside the basic nature of the host
2-the heard voices and the imaginary pictures and the temperamental feelings are the vibrant existential features
=the hallucinations is the scientific name for the vibrant existential features
=the hallucinations in its nature is merely an existential entities not from
our natural world,they are metaphysical entities
=when these entities appear themselves inside the basic nature of a
human being,the symptoms which so-called delusional believes /beliefs
are the self-explanation {cognitive explanation-religious explanation} for
the existential features !

{{look at the talking of any schizophrenic,he talks about people reading
his thoughts,hearing them voices and he does not talking about
organic symptoms of disease }



the mental behaviors of the schizophrenic individual
remains for what is it,until external force or self-volition
affects the internal status,thereby alternating / modification the nature
of his mental behavior
"the same understanding to the second law of Newton "

this means that,the modification of behavior of the schizophrenic has needed to
self or external intervention all time of waking

the medical drugs can not modify the behavior or its directions



i thought this forum was a CBT for psychosis :wink:



Im all for meds…some people dont need them, but it’s rare to find someone who doesnt repeatedly find themselves without an occupation, getting committed/arrested, and generally living well who arent on meds. Rare but not impossible. I for one DID get committed while not on antipsychotics, I was also half-assing school and drinking fireball whiskey like water every night, and a couple shots in my coffee every morning, and sometimes a beer before hitting the gym.

I personally want to express my opinion that medication is NECESSARY for MOST but not ALL of us. CBT helped me function while being an alky and student, but meds got my life back to normal. My psychologist at the time was rather pragmatic, he stated that I was functioning very highly and that alcohol was effective self medication and that from that standpoint, I was actually beating the odds against my diagnosis. When I went to my psychiatrist he stated that I was already functionally in remission and that anitpsychotics are not fun and “nothing to fool with” and asked me repeatedly if I really wanted to get on one. I explained that I was drinking as self medication and getting tired of the alcoholic lifestyle and he was like “alright. You’ll have to quit drinking altogether and slowly get on Geodon” after we talked about meds for a couple of minutes and decided on Geodon due to its low sedation and weight gain. It took months to find the right dose, but it worked. Bye Bye voices, delusions and 4 hours of nightmares. Hello sanity. It had been a while and I felt like I didnt know what to do with myself when I woke up sane one morning on after taking 120mg of Geodon the previous day. I had akathisia, ie med induced restless leg syndrome, and he put me on two more meds to counter it and relieve my newly discovered anxiety disorder separate from schizophrenia.

CBT is like a nerf gun. Meds with CBT is like a sawed off shotgun to the balls.



Sorry, but I don’t get what you’re saying here…it’s painful?



at work, CBT = Computer Based Training , so when I first read this, I thought it was a posting about psychosis training :smiley:

I, for one, don’t want to be trained on how to be psychotic :slight_smile:



@Twang He’s saying it will knock your socks off.



I find it hard to believe the combination is magical.



lol no, its effective at killing schizophrenia.