From the start of the assessment it is vital to use the person's own terminology for their psychotic experiences. The ultimate goal of the therapist is to try to understand, rather than to try to make the person change their mind by challenging the reality of their voices and delusions.
The role of emotion in psychosis has been neglected, which has led to emotional problems been under-recognized and rendered subordinate to the psychosis symptoms. Few effective therapeutic treatments have been introduced for the management of emotional disorders in psychosis.
The origins of auditory hallucinations may be misattributed cognitions such as inner speech, disconnected memories or traumatic flashbacks. It is important to establish what can be done to help people who are distressed.
Dysfunctional negative beliefs and attitudes may play a role in negative symptoms and formal thought disorder. Cognitive therapy can be used to uncover such beliefs and to determine alternative viewpoints.
Normalising is a main factor predicting a good clinical outcome when it is linked to other formulation techniques such as tracing the antecedents of breakdown, decatastrophising schizophrenia and education about illness.
There is a worldwide movement of early intervention for psychosis. This paper reviews the role of cognitive behaviour therapy for first-episode individuals as part of a comprehensive treatment and also for those at clinical high-risk.
