ABSTRACT
Cognitive therapy of course is focused on the meaning that individuals attribute to events that happen around them. When a person comes into therapy it is often because their understanding of themselves, the world and the future is dysfunctional in some way. Strauss demonstrated the existence of a spectrum of belief from normal beliefs through overvalued ideation to delusions, the dominant view remains that delusional beliefs are separate entities from normal beliefs. Cognitive behavioural therapists will be familiar with typical schema or core dysfunctional assumptions; however, Fowler, Garety, and Kuipers encountered five main schematic themes among people with psychosis: the self is extremely vulnerable to harm, one is highly vulnerable to losing self-control, the self is doomed to social isolation, inner defectiveness, unrelenting standards. It is the opinion that a formulation demonstrating coherence between life events, underlying schematic vulnerabilities, and resultant psychotic symptoms is the key principle guiding the course of cognitive therapy with a psychotic patient.
