Cognitive Therapy for Delusions in Schizophrenia: Models, Benefits, and New Approaches

Abstract

The main purpose of the review is to demonstrate how cognitive models of psychosis translate into cognitive-behavioral approaches for intervening with psychotic symptoms in schizophrenia. Several cognitive-behavioral factors which play a role in the maintenance and possibly formation of delusional beliefs are discussed, including attentional bias to threat, “data gathering” deficits, dysfunctional metacognition, and safety behaviors. Strategies for engagement, problem formulation, and psychoeducation with deluded patients are described. Cognitive-behavioral interventions are presented, specifically, cognitive restructuring, behavioral experiments, and coping skills training. Challenges to conducting cognitive-behavioral therapy (CBT) with delusions in schizophrenia are reviewed. Novel cognitive therapies, which address these challenges, are presented.