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An Overview of Cognitive Behaviour Therapy in Schizophrenia Spectrum Disorders

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Handbook of Schizophrenia Spectrum Disorders, Volume III

Abstract

Cognitive behaviour therapy (CBT) has become a treatment of choice for several schizophrenia spectrum disorders. This chapter traces the development of CBT from early attempts at thought stopping to more recent developments of cognitive therapy specialized for psychosis. CBT strategies have drawn on information processing biases such as threat bias, attentional bias, reasoning bias, data gathering bias, externalizing bias, lack of agency, and intention initiation. Meta-analytic reviews of the efficacy of CBT in psychosis have shown strong effect sizes when compared with no treatment but less strong when compared to supportive therapy, and proportions of clinically significant change have often not persisted between CBT and comparison therapies at follow-up. Although current CBT programs share common theoretical foundations and follow a similar format of preparation, restructuring and reality testing, experimental findings and clinical strategies differ for specific spectrum disorders. In addition, CBT programs have been tailored to specific stages of development, such as early onset or relapse prevention. There is also a trend towards limiting the targets of CBT intervention to focus on alleviating specific features such as emotional distress, or level of beliefs, or degree of preoccupation, rather than addressing core beliefs. Further challenges for CBT include improving access to and treatment delivery of CBT to diverse populations and through diverse professions. There have recently been attempts in UK and elsewhere to set up pyramid training and to encourage community settings to implement best practices. Alternative treatment delivery involves group formats and new technologies including computer and teleconferences following step care models.

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Abbreviations

APA:

American Psychiatric Association

CBT:

Cognitive behaviour therapy

COPE:

Psychosocial interventions for psychosis pathways

SCIT:

Social cognition and interaction training

SoCRATES:

Study of cognitive reality alignment therapy in early psychosis

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Authors and Affiliations

  1. Fernand-Seguin Research Centre, Louis-H. Lafontaine Hospital, University of Montreal, Montreal, QC, Canada

    Kieron O’Connor & Tania Lecomte

  2. Department of Psychoeducation and Psychology, University of Quebec in Outaouais, Gatineau, QC, Canada

    Kieron O’Connor

  3. Department of Psychology, University of Montreal, Montreal, QC, Canada

    Tania Lecomte

Authors
  1. Kieron O’Connor
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  2. Tania Lecomte
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Correspondence to Kieron O’Connor .

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Editors and Affiliations

  1. , Rappaport Faculty of Medicine, Technion - Israel Institute of Technolog, Haifa, Israel

    Michael S. Ritsner

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O’Connor, K., Lecomte, T. (2011). An Overview of Cognitive Behaviour Therapy in Schizophrenia Spectrum Disorders. In: Ritsner, M. (eds) Handbook of Schizophrenia Spectrum Disorders, Volume III. Springer, Dordrecht. https://doi.org/10.1007/978-94-007-0834-1_12

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