Cognitive behavioural therapy for thought disorder in psychosis
Open accessAbstract
Clinicians are often sceptical about offering cognitive behavioural therapy (CBT) to individuals experiencing thought disorder. This view may result from perceived difficulties in clients being able to learn and better understand their experiences through verbal dialogue. However, it may also partly be due to the lack of clear guidance on how to address and work with these difficulties within therapy. This paper provides recommendations for delivering CBT in individuals experiencing thought disorder. It considers how clinicians might conduct their cognitive behavioural assessment, formulation, and intervention, targeting unhelpful appraisals and behaviour, and generating insight. The aim is to better disseminate the techniques sometimes applied in clinical practice.
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Acute psychotic symptoms such as extreme emotional distress, thought disorder, and acute hallucinations or delusions can make engagement in psychological therapy a challenge.
“For example, acute psychotic symptoms such as extreme emotional distress, thought disorder, and acute hallucinations or delusions can make the engagement in psychological therapy a challenge due to difficulties concentrating in sessions and finding the development of new relationships potentially threatening (Palmier-Claus et al., 2017, Clarke and Wilson, 2008).”
From A systematic review and meta-analysis of cognitive behavioural informed psychological interventions for psychiatric inpatients with psychosis (2020) · cites this paper as Palmier-Claus et al., 2017
The Discussion (page unavailable) says that people with high levels of thought disorder are often excluded from CBT trials because of perceived difficulties engaging, and the Structure of sessions section recommends attention to engagement and rapport. The paper also discusses stress worsening thought disorder, but the passages do not establish that acute hallucinations or delusions impede engagement, or that developing new therapeutic relationships feels threatening. (LLM, conf=0.86)
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- Authors
- Palmier-Claus, J., Griffiths, R., Murphy, E., Parker, S., Longden, E., Bowe, S., Steele, A., French, P., Morrison, A., & Tai, S.
- Affiliations
- Psychosis Research Unit, Greater Manchester Mental Health NHS Foundation Trust, Manchester, UK
- University of Manchester (GB)
- Greater Manchester Mental Health NHS Foundation Trust (GB)
- ORCID
- Venue
- Psychosis
- Publisher
- Informa UK Limited
- Published
- 2017-08-11
- Volume
- 9
- Issue
- 4
- Pages
- 347-357
- ISSN
- 1752-2439 (ISSN-L)
- 1752-2447
- OpenAlex
- W2745277742
- Cited by
- 14
- References
- 42
- Citations by year
- 2026: 1 · 2024: 3 · 2023: 1 · 2022: 1 · 2021: 2 · 2020: 2 · 2019: 2 · 2018: 2
- FWCI
- 1.35
- Type
- journal article
- Language
- en
- Open access
- green
- eprints.lancs.ac.uk
- Locations
- Psychosis (publishedVersion)
- Lancaster EPrints (Lancaster University) (submittedVersion)
- RePEc: Research Papers in Economics (submittedVersion)
- Research Explorer (The University of Manchester) (submittedVersion)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Schizophrenia research and treatment
- Social Sciences › Psychology › Clinical Psychology › Psychological Treatments and Assessments
- Social Sciences › Psychology › Clinical Psychology › Psychotherapy Techniques and Applications
- Keywords
- cognitive behavioral therapy, thought disorder, therapeutic formulation, insight generation, clinical guidelines
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