Treating trauma in people with first-episode psychosis using cognitive behavioural therapy
This chapter provides brief illustrative case studies that show the reader how cognitive behavioural therapy is adapted to take account of trauma processes. People with psychosis experience high rates of trauma as children and/or as adults. This knowledge presents a number of challenges for clinicians. For some, early childhood traumatic experiences seem to be a key vulnerability for later life difficulties, including the development of psychosis. Traumatic incidents such as violent or sexual assault or rape may act as stressors for some people that exceed the person's capacity to cope and therefore precipitate a psychotic breakdown. Once again, there is a particular association with trauma seeming to act as a trigger for hallucinations. Experimental research has indicated that trauma experiences can be interpreted differently according to pre-existing information-processing styles. Interestingly, this reveals a possible interaction between those people who are perhaps more predisposed to psychotic experiences and the impact of traumatic experiences.