Coping With Psychological Distress Associated to Positive Symptoms of Schizophrenia: A Brief Cognitive Behavioral Intervention

Abstract

This case study examined the assessment, treatment, and outcomes of a 53-year-old man presenting with chronic paranoid schizophrenia. This individual presented with significant anxiety, stress, and depression symptoms resulting from his inability to cope with persistent and persecutory auditory hallucinations and delusions. The treatment approach was drawn from principles of cognitive behavioral therapy, in particular the Coping Strategy Enhancement Approach (CSE; Yusupoff & Tarrier, 1996). This approach is used for people suffering from persistent hallucinations and delusions. The CSE aims to assist the individual develop adaptive coping strategies in the physiological, cognitive, and behavioral domains. Findings suggested a reduction in depression, anxiety, and stress reported during the course of the interview despite the persistent and significant positive symptoms. Furthermore, the participant reported increased confidence in managing these symptoms and developed simple and reportedly effective coping skills. As results supported the use of the cognitive behavior therapy (CBT) approach, the findings were moderate. There were several factors contributing to these results, such as lack of consistent carer support and the intellectual impairments associated with the illness. These factors are described in the study, with recommendations for future interventions.