Treatment Approaches for Schizophrenia and Psychosis: Cognitive Behavioral and Social Cognitive Interventions
Main Article Content
Abstract
Evidence-based practices and treatments for schizophrenia and psychosis are especially helpful in moving these individuals towards recovery. High levels of disability, cost, and resistant symptoms are problems for clinicians working with schizophrenia patients. Even with optimal medication treatment, about half of schizophrenia patients show residual psychotic symptoms such as delusions and paranoia. Two effective treatments for psychosis include Cognitive Behavioral Therapy for Psychosis and Social Cognition and Interaction Training. Both treatments have demonstrated efficacy in both randomized clinical trials and across multiple meta-analyses. This paper focuses on the treatment of paranoia and delusions using Cognitive Behavioral Therapy for Psychosis and Social Cognition and Interaction Training as a way to address and modify these beliefs and the dysfunctional cognitive processes that underlie adaptive social interactions. Even though these treatments are different in their methods and procedures, they are an integral part of a multi-focused approach to the treatment of psychosis. Research findings, treatment examples, rationale for use, and intervention techniques are highlighted, reviewed, and discussed. Using interventions that have sound research support is crucial in helping individuals with schizophrenia towards personal, social, and occupational recovery.
Article Details
How to Cite
MENSHAUSEN, Chelsea et al.
Treatment Approaches for Schizophrenia and Psychosis: Cognitive Behavioral and Social Cognitive Interventions.
Medical Research Archives, [S.l.], v. 14, n. 6, june 2026.
ISSN 2375-1924.
Available at: <https://esmed.org/MRA/mra/article/view/6692>. Date accessed: 02 july 2026.
doi: https://doi.org/10.18103/mra.v14i6.6692.
Section
Research Articles
The Medical Research Archives grants authors the right to publish and reproduce the unrevised contribution in whole or in part at any time and in any form for any scholarly non-commercial purpose with the condition that all publications of the contribution include a full citation to the journal as published by the Medical Research Archives.
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2. Keepers GA, Fochtmann LJ, Anzia JM, et al. The American Psychiatric Association Practice Guideline for the Treatment of Patients With Schizophrenia. Am J of Psychiatry. 2020;177(9):868-872.
https://doi:10.1176/appi.ajp.2020.177901.
3. Harvey PD, Strassnig MT, Silberstein J. Prediction of disability in schizophrenia: Symptoms, cognition, and self-assessment. J Exp Psychopathol. 2019;10(3). https://doi:10.1177/2043808719865693
4. Mueser KT, McGurk SR. Schizophrenia. Lancet. 2004;363(9426):2063-2072. https://doi:10.1016/S0140-6736(04)16458-1.
5. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders. 5th ed. Washington D.C.: 2013.
6. Combs DR, Mueser KT, Morales S, Smith C. Schizophrenia Spectrum and Other Psychotic Disorders. In: Beidel DC, Frueh BC, eds. Adult Psychopathology & Diagnosis. 8th ed. New York, NY: Wiley Press; 2018: 159-208.
7. Rector NA. Cognitive theory and therapy of schizophrenia. In: Leahy RL, ed. Contemporary Cognitive Therapy: Theory, Research, and Practice. New York, NY: Guilford Press; 2006: 244-268.
8. Kurtz MM, Gagen E, Rocha NB, Machado S, Penn DL. Comprehensive treatments for social cognitive deficits in schizophrenia: A critical review and effect-size analysis of controlled studies. Clin Psychol Rev. 2016;43:80-89. https://doi:10.1016/j.cpr.2015.09.003.
9. Salahuddin NH, Schütz A, Pitschel-Walz G, et al. Psychological and psychosocial interventions for treatment-resistant schizophrenia: a systematic review and network meta-analysis. Lancet Psychiatry. 2024;11(7):545-553. https://doi:10.1016/S2215-0366(24)00136-6.
10. Roberts DL, Penn DL, Combs DR. Social Cognition and Interaction Training (SCIT): Group Psychotherapy for Schizophrenia and Other Psychotic Disorders Clinician Guide. Oxford University Press; 2016.
11. Beck JS, Fleming S. A brief history of Aaron T. Beck MD, and Cognitive Behavior Therapy. Clin Psychol Eur. 2021;3(2). https://doi:10.32872/cpe.6701.
12. American Psychological Association Presidential Task Force on Evidence-Based Practice. Evidence-based practice in psychology. Am Psychol. 2006;61(4), 271-285.https://doi:10.1037/0003-066X.61.4.271.
13. Combs DR, Mueser KT. Schizophrenia and Severe Mental Illness. In D. McKay, J.S. Abramowitz, & E.A. Storch (Eds.), Treatments for Psychological Problems and Syndromes (pp. 188-201). Wiley Press; 2017.
14. Freeman D, Garety PA. Helping patients with paranoid and suspicious thoughts: A cognitive-behavioral approach. Adv Psychiatr Treat. 2006;12(6):404-415. https://doi:10.1192/apt.12.6.404.
15. Gaudiano BA. Cognitive Behavior Therapies for Psychotic Disorders: Current Empirical status and Future Directions. Clinical Psychology Science and Practice. 2005;12(1):33-50. https://doi:10.1093/clipsy/bpi004.
16. Rector NA, Beck AT. Cognitive Behavioral Therapy for schizophrenia: An empirical review. J Nerv Ment Dis. 2001;189(5), 278-287. https://doi:10.1097/00005053-200105000-00002.
17. Wykes T, Steel C, Everitt B, Tarrier N. Cognitive behavior therapy for schizophrenia: effect sizes, clinical models, and methodological rigor. Schizophr Bull. 2008;34(3), 523–537. https://doi:10.1093/schbul/sbm114.
18. Zimmerman G, Favrod J, Trieu VH, Pomini V. The effect of cognitive behavioral treatment on the positive symptoms of schizophrenia spectrum disorders: A meta-analysis. Schizophr Res. 2005;77(1), 1-9. https://Doi:10.1016/j.schres.2005.02.018.
19. Wood L, Williams C, Billings J, Johnson S. A systematic review and meta-analysis of cognitive behavioural informed psychological interventions for psychiatric inpatients with psychosis. Schizophr Res. 2020; 222:133-144. https://doi:10.1016/j.schres.2020.03.041
20. Chadwick P, Birchwood MJ, Trower P. Cognitive Therapy for Delusions, Voices, and Paranoia. J. Wiley. Published 1996. Accessed June 2, 2025. https://doi.org/10.1007/978-3-031-11677-3_21.
21. Cather C., Penn D, Otto MW, Yovel I, Mueser KT, Goff DC. A pilot study of functional cognitive behavioral therapy for schizophrenia. Schizophr Res. 2005; 74(2), 201-209. https://doi:10.1016/j.schres.2004.05.002.
22. Roberts DL, Penn DL, Cather C, Otto M, Goff DC. Should CBT target the social impairments associated with schizophrenia? J Cogn Psychother. 2004; 18(3), 255-264. https://doi:10.1891/jcop.18.3.255.65651.
23. Joseph HL, De Andino AM, Wood K. Group cognitive-behavioral therapy via telebehavioral health for those with psychotic spectrum disorders: A case series. Cogn Behav Pract. 2021;28(4), 716-729. https://doi.org/10.1016/j.cbpra.2021.06.007.
24. Sitko K, Bewick BM, Owens D, Masterson C. Meta-analysis and meta-regression of cognitive behavioral therapy for psychosis (CBTp) across time: The effectiveness of CBTp has improved for delusions. Schizophr Bull Open. 2020;1(1). https://doi.org/10.1093/schizbullopen/sgaa023.
25. Wykes T, Steel C, Everitt B, Tarrier N. Cognitive behavior therapy for schizophrenia: Effect sizes, clinical models, and methodological rigor. Schizophr Bull Open. 2008;34(3):523-537. https://doi:10.1093/schbul/sbm114.
26. Bighelli I, Salanti G, Huhn M, Schneider-Thoma J. et al. Psychological interventions to reduce positive symptoms in schizophrenia: Systematic review and network meta-analysis. World Psychiatry. 2018;17(3), 316-329. https://doi.org/10.1002/wps.20577.
27. Peters E, Landau S, McCrone P, et al. A randomised controlled trial of cognitive behaviour therapy for psychosis in a routine clinical service. Acta Psychiatrica Scandinavica. 2010;122(4):302-318. doi:https://doi.org/10.1111/j.1600-0447.2010.01572.x.
28. Sitko K, Bewick BM, Owens D, Masterson C. Meta-analysis and meta-regression of cognitive behavioral therapy for psychosis (CBTp) across time: the effectiveness of CBTp has improved for delusions. Schizophr Bull Open. 2020; 1(1). https://doi.org/10.1093/schizbullopen/sgaa023
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