Psychological Treatment of Psychosis

Psychological treatments for psychosis have been widely studied over many years. Early studies were mainly in the form of individual case studies or case series. However, more recently, treatments have been evaluated in larger, controlled trials, leading to a larger evidence base on which to judge their effectiveness. This evidence base suggests that certain approaches can be effective in reducing the severity and distress associated with psychosis and some of these have become more widely employed in the treatment of severe mental health problems over the last decade in the UK, Europe, and the US. Generally, the treatments with the greatest evidence base in psychosis are in the following treatment domains: (1) individual cognitive and behavioral therapies; (2) family interventions for psychosis; (3) neuropsychological and cognitive remediation approaches; (4) social skills training and other skills training approaches; and (5) contingency management approaches. Characteristics of the approaches are described, using clinical examples and evidence in support of their effectiveness. The implications for applying the approaches with complex cases, such as those with dual diagnoses, are described. Finally, the challenges facing services in implementing the approaches is discussed. © 2011 Blackwell Publishing Ltd.