Cognitive Behavioural Psychotherapy with a person presenting with a second episode of psychosis: A Case Report
Main Article Content
Abstract
Background: Mental health services are prioritizing the delivery of Cognitive Behavioural Psychotherapy (CBTp) for people with psychosis. However, it is recognized that there is scope to further research and to adapt this evidenced based therapy for the client group. Recovery processes could also be explored. Single case designs may be informative in gaining detailed knowledge of the nuances in how individuals respond to CBTp.
Case report: This case report investigates an individual’s response to CBTp, within the context of a secondary care service. The person, aged in her 30’s, was recovering from a second episode of psychosis and was presenting with residual symptoms linked with a delusion. The intervention incorporated: the stress vulnerability framework, identifying maladaptive cognitive processes, challenging cognitions, decision making and a behavioral experiment. Positive Psychotherapy (PPT), which aligns with recovery was integrated into the therapy. The case report details the person’s response up until session ten of twenty-three appointments. Idiosyncratic measures of emotion and cognition were recorded. There was a decrease in the client’s level of anxiety and in the intensity of the negative cognition. The client gained a cognitive understanding of the connection between negative cognition as a maintaining factor in psychosis and actively managed this. Moreover, there was a notable increase in the person’s level of functioning.
Conclusion: The findings indicate that CBTp is beneficial in: reducing anxiety, tempering negative thoughts as well as improving functioning. Evidently CBTp can be delivered with Positive Psychotherapy and there are gains in doing so. However, further research is required in monitoring individual responses to specific therapeutic processes. Future single case research could also explore the novel finding that internet use triggers and maintains processes underpinning delusions.
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