Cognitive therapy for psychosis: Formulation, treatment, effects and service implications

Cognitive and cognitive behavioural therapies for psychosis involve talking to patients about their symptoms and life predicament, and attempting to make sense of such problems in terms of a cognitive formulation of psychosis. The aim is to engage in collaborative discussions which lead to the fostering of less distressing and more constructive ways of understanding psychosis, and behaviour likely to promote recovery. Recent randomised controlled treatment trials provide strong evidence that such therapies can have a significant impact on the symptoms and problems presented by people with psychosis. This paper outlines the formulation and treatment approach of cognitive behavioural therapy for psychosis, provides a brief review of the findings of recent controlled treatment trials, and addresses issues relating to how cognitive behavioural therapies might be integrated within mainstream mental health services.