ABSTRACT
This chapter covers the rapidly growing area of cognitive-behavioural therapy in schizophrenia. It considers the use of developing a rationale with patients to explain symptom emergence and decatastrophise the psychiatric diagnosis of schizophrenia. An integrated treatment strategy with a community key worker is the backbone of community management of patients with schizophrenia. The maintaining factors for negative symptomatology are frequently preoccupation with positive symptoms, neuroleptic side effects and depression. The process of therapy is described in tandem with the use of low dose medication and standard behavioural rehabilitation approaches. One of the main cognitive-behaviour therapy techniques involved in treating schizophrenic thought disorder is thought linkage. In this technique the patient is repeatedly asked to clarify the links between disconnected fragments of speech. The use of cognitive-behaviour therapy with a normalising rationale in schizophrenia is being scientifically evaluated. Studies have been designed and funded to measure compliance with neuroleptics and outcome, and to measure efficacy on an ‘intention to treat’ basis.
