AO2 CBT for schizophrenia

Michael has been struggling with his mental health for a while now. He is convinced that he is being followed by secret agents who are broadcasting his thoughts on the internet for everyone to judge. Despite reassurances from friends and no evidence to support his belief, he spends hours searching the web for these broadcasts. He feels so scared that he finds it hard to leave his apartment or engage in any activities he used to enjoy, often spending days without talking to anyone.

Michael's CBT therapist begins therapy with ​ (a)   . This would help him understand the connection between his ​ (b)   (e.g., his belief that secret agents are following him), his ​ (c)   (searching the web for broadcasts and staying inside) and his ​ (d)   (he is scared). Helping Michael to understand their symptoms can make the illness seem more manageable, thereby reducing distress and helping the patient engage with the rest of the therapy.

• psychoeducation
• thoughts
• emotions
• behaviour
• cognitive therapy
• behavioural skills training

Michael has been struggling with his mental health for a while now. He is convinced that he is

being followed by secret agents who are broadcasting his thoughts on the internet for

everyone to judge. Despite reassurances from friends and no evidence to support his belief,

he spends hours searching the web for these broadcasts. He feels so scared that he finds it

hard to leave his apartment or engage in any activities he used to enjoy, often spending days

without talking to anyone.

Michael's CBT therapist then uses ​ (a)   to address Michael's belief that he

is being followed by secret agents. The therapist could ask Michael to make a list of the evidence

supporting his belief and the evidence that might challenge his belief, allowing him to evaluate how

confident he should be in his belief that secret agents are folloing him.

to address Michael's belief that he is being followed by secret agents.

• cogntive therapy for delusions
• cogntive therapy for hearing voices
• behavioural skills training
• psychoeducation

Michael has been struggling with his mental health for a while now. He is convinced that he is

being followed by secret agents who are broadcasting his thoughts on the internet for

everyone to judge. Despite reassurances from friends and no evidence to support his belief,

he spends hours searching the web for these broadcasts. He feels so scared that he finds it

hard to leave his apartment or engage in any activities he used to enjoy, often spending days

without talking to anyone.

Michael's CBT therapist could then use __________ ________ _______ to teach Michael some

actions he could take to help him address his distress and the negative symptoms he is experiencing.

For example, he could be taught to use controlled breathing when he feel scared, to help calm him

down.

Emily often reports seeing shadows that speak to her, telling her she is chosen for a special

mission to save the world. These experiences are vivid and cause her significant distress, as

she feels overwhelmed by this responsibility. Despite her family's attempts to comfort her,

she insists these experiences are real. Emily has also lost interest in painting and writing,

hobbies she once loved, claiming that they feel pointless now.

Explain how CBT could be used to treat Emily's schizophrenia. [6 marks]

One CBT technique that could be used to treat Emily is psychoeducation . This involves educating the patient about their condition using the stress-vulnerability model (see image below). This teaches them the links between their thoughts, feelings, and behaviors, with the aim of helping them understand their condition and so make it seem more managable and less distressing.

This could help Emily by...[outline how psychoeducation could be used on Emily and/or why it would help her. Aim to apply key parts of the outline info set out on psychoeducation and link it to the stem]

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Lucas is troubled by hearing an incessant whispering that criticizes his every action, making him

extremely anxious and paranoid that everyone can hear this voice and knows how bad a person he

is. This has led him to isolate himself, spending most of his time alone in his room, neglecting his

personal hygiene and showing no interest in previously enjoyable activities.

Explain how CBT could be used to treat Lucas's schizophrenia. [6 marks]

One CBT technique that could be used to help Lucas is cognitive therapy for hallucinations. This involves the therapist guiding the patient to explore the rationality of their beliefs their voices, with the aim of changing beliefs that cause distress.    ​ 

This could be used to help Lucas by...[outline what the therapist would do and how this could help Lucas]

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Lucas is troubled by hearing an incessant whispering that criticizes his every action, making him

extremely anxious and paranoid that everyone can hear this voice and knows how bad a person he

is. This has led him to isolate himself, spending most of his time alone in his room, neglecting his

personal hygiene and showing no interest in previously enjoyable activities.

Explain how CBT could be used to treat Lucas's schizophrenia. [6 marks]

One CBT technique that could be used to help Lucas is cognitive therapy for hallucinations. This involves the therapist guiding the patient to explore the rationality of their beliefs their voices, with the aim of changing beliefs that cause distress.    ​ 

This could be used to help Lucas by...[outline what the therapist would do and how this could help Lucas]

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Jordan believes that his coworkers are part of a conspiracy to harm him, interpreting their friendly

gestures as coded threats. He hears derogatory voices commenting on his actions, making it difficult

for him to concentrate at work or interact with others. As a result, Jordan has started to call in sick

frequently, spending his days at home where he feels safer but shows no interest in engaging in any

activities, stating that nothing seems worthwhile anymore.

Explain how CBT could be used to treat Jordan's schizophrenia. [6 marks]

One CBT technique that could be used to help Lucas is cognitive therapy for delusions. This involves the therapist guiding the patient to explore the rationality of their delusional beliefs, with the aim of changing beliefs that cause distress.    ​ 

This could be used to help Jordan by...[outline what the therapist would do and how this could help Lucas]

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Sara tells her doctor that she receives secret messages through television shows, instructing her on

how to avoid an impending global catastrophe. She becomes agitated when her family tries to

convince her that these beliefs are unfounded. Sara has also stopped attending college classes,

explaining that she feels so stressed that she can't focus in lessons.

Exlain how CBT could be used to treat Sara's schizophrenia. [6 marks]

One way CBT could be used to treat Sara's schizophrenia is through behavioural skills training. In this technique, the therapist works with the patient to agree on behavioural actions the patient could take to reduce the stress caused by the symptoms.

This could help Sara by...[outline how behavioural skills training could be used and why it would help Sara]

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