ABSTRACT
In this chapter, the authors outline current cognitive theory on mechanisms of therapeutic change, and the implications for responding mindfully to psychosis. They describe the practicalities of introducing and teaching mindfulness in the context of CBT for psychosis. CBT aims to support people's recovery by working collaboratively to understand the development and maintenance of distressing psychosis and enable people to make changes on the basis of this formulation, in line with their goals and aspirations. In CBT for psychosis, the authors use behavioural approaches to address overt avoidance and safety behaviours; encourage reflection on, and reconsideration of distressing appraisals; and introduce mindfulness as a means of disengaging from judgement and habitual processing patterns, in line with the person's goals. Psychosis can reflect and form the basis for narrow, fixed and condemnatory self-definition. When people judge themselves by their psychosis, they seek to support an acceptance of the complexity of internal experience and the self.
