ABSTRACT
This chapter describes the development of different types of cognitive therapy for psychosis. This has been a great success for promoting a psychological approach to psychosis. As the therapy has changed, the theory underpinning the therapy has also evolved. CBT of psychosis focuses on symptoms rather than syndromes. The theories of Maher, Bentall and Morrison and Chadwick and colleagues are critically reviewed. Technically, differences between different cognitive therapies are detailed. Birchwood’s cognitive therapy for command hallucinations is reviewed. This involves addressing the personification of the voices which the client hears. It is suggested that clients’ personification of their voices is not explained by the model. Furthermore, the more bizarre experiences of psychosis; for example, passivity phenomenon and thought insertion are not explained by the CBT model. Rather, the CBT model of psychosis is borrowed from a model developed with emotional disorders. It is suggested that the theory is hampered by taking an atomistic view of the symptoms of psychosis rather than a gestalt view of the various symptoms and problems. Finally, Paul Lysaker’s MERIT therapy is described. It is concluded that the theories of the symptoms of psychosis in CBT do not explain the experience of psychosis.
