ABSTRACT
This chapter considers the principles and structure of cognitive therapy for psychosis, both in relation to individual treatment sessions and the overall sequence of therapy. Structure in treatment is an essential characteristic of cognitive therapy regardless of diagnosis. Structure within individual sessions helps both patient and therapist to focus on a specific topic and the related discrete targets. It enhances collaboration and fosters shared responsibility for session content, setting the scene for shared responsibility for activity both in sessions and between sessions. Longitudinal structure is important when summarising treatment both during the active phase and when addressing relapse management. Demonstrating and sharing a structured logical process in therapy helps the patient make sense of therapy, both during and after the event. The patient needs to know what has been covered and why, and what is to come during active treatment. Planning relapse prevention or management focuses on the gains the patient has made, how they were made, what skills were acquired, and how they will be put into practice in the future.
