ABSTRACT
The Coping Strategy Enhancement (CSE) approach for persistent hallucinations and delusions is characterised by its emphasis on an individually formulated training programme to enhance symptom self-management skills. This chapter begins with a brief background to the approach and basic conceptual model, followed by a summary of research findings from an initial controlled trial of CSE. The CSE approach supports the view that attitudes to symptoms should be clarified at the outset of therapy where possible and addressed where appropriate. Hallucinations and delusional beliefs occur in subjective and social contexts and thus symptoms assume significance and meaning only when there is an accompanying emotional reaction. Motivational considerations are pertinent to therapeutic interventions for any clinical problem, although there may be specific issues with regard to the loss or change of persistent hallucinations and delusions. The motivational factors may be readily accessible by the use of appropriate questioning.
