Understanding Cognitive Behavioural Therapy for Psychosis (CBTp)
If you’ve been offered Cognitive Behavioural Therapy for Psychosis (CBTp), you might have questions about what it is, how it works, and how it can help. This page explains the basics and answers some common questions.
What is psychosis?
People with a diagnosis of psychosis might experience:
- Hearing voices or seeing things others don’t (sometimes called hallucinations)
- Beliefs that others might find unusual or untrue (sometimes called delusions)
- Confusion and problems with concentrating or organising thoughts
These experiences can be distressing and can leave people feeling unsafe. People with a diagnosis of psychosis often find medication and/or talking therapies helpful in learning to cope with these difficulties.
What is CBTp and why can it be helpful?
Cognitive Behavioural Therapy (CBT) is an evidence-based talking therapy that can help you understand how your thoughts and beliefs (cognition) influence feelings and behaviour.
Cognitive Behavioural Therapy for Psychosis (CBTp) focuses on:
- Exploring your experiences (such as hearing voices or having unusual beliefs) and how they affect you.
- Finding practical ways to manage distress caused by these experiences, to improve your quality of life.
CBT does not aim to challenge your experiences. Instead, it involves working collaboratively with a therapist to make sense of things in a safe way, and to find strategies which can help build confidence and feelings of safety.
CBT has been shown to be an effective therapy to help people live well with psychosis and is recommended for use in the NHS.
What happens in CBTp?
You’ll work with a trained therapist, usually for at least 16 sessions over several months. Sessions may include:
- Getting to know you: Your therapist will want to learn about your experiences and what is important to you.
- Understanding psychosis: Learning together with your therapist about how you are feeling and finding helpful ways forward.
- Setting goals: Together, you’ll identify areas you’d like to work on, such as spotting patterns or situations that lead to changes in how you feel.
- Coping techniques: Developing practical tools to help reduce anxiety and stress and build feelings of safety.
- Challenging unhelpful thoughts: Reflecting on how we think and images that come to mind, particularly when we feel worried or distressed.
- Building resilience: Strengthening your ability to cope and plan for the future.
Common questions
Will CBT make my experiences go away?
CBT doesn’t focus on stopping voices or unusual beliefs. You and your therapist will work together to find ways to understand and manage them. Many people find their experiences become less distressing.
Is CBT suitable for me?
Many people find CBT useful, but it’s not the right fit for everyone. Your therapist or mental health team will work with you to assess if it’s a good fit for your needs. CBT works best when you actively take part and stay committed. CBT can be tailored to suit your needs, whether you’re newly diagnosed or have lived with psychosis for some time.
Do I have to talk about everything?
Your therapy is a safe, confidential space. You’re in control of what you discuss.
How do I access CBTp?
Speak to your mental health practitioner about how to access CBT or other psychological therapies that may suit your individual needs and circumstances.
You are not alone
Remember, you are not alone.
CBTp can be a valuable tool in coping with mental health problems and improving your overall wellbeing.
As a service user, relative or carer using our services, sometimes you may need to turn to someone for help, advice, and support.
Find resources for carers and service users Contact the Trust