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Cognitive-Behavioral Therapy for Schizophrenia: A Review

TURKINGTON, DOUGLAS MD; DUDLEY, ROBERT PhD; WARMAN, DEBBIE M. PhD; BECK, AARON T. MD

Journal of Psychiatric Practice: January 2004 - Volume 10 - Issue 1 - pp 5-16
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Cognitive-behavioral therapy (CBT) has a proven role as an adjunct to antipsychotic medication and remediative approaches such as social skills training in the management of residual symptoms of chronic schizophrenia. Positive symptoms, depression, and overall symptoms appear to be viable treatment targets for CBT with a less pronounced effect on negative symptoms. The effect size at end of therapy is strong, with durability at short-term follow up. CBT can be used safely in patients with schizophrenia, and caregivers can help with homework exercises. There is also evidence that psychiatric nurses in the community can use CBT effectively with this patient group under supervision. CBT can be combined with family therapy and assertive community treatment programs targeted to reduce relapse. CBT improves the coping of patients with schizophrenia through improved adherence and symptom management. CBT techniques include development of trust, normalizing, coping strategy enhancement, reality testing, and work with dysfunctional affective and behavioral reactions to psychotic symptoms. An enhanced response to CBT would be expected when given with low dose cognitively enhancing atypical antipsychotic medication.

TURKINGTON: Royal Victoria Infirmary, Newcastle-Upon-Tyne; DUDLEY: Newcastle Cognitive and Behavioural Therapies Centre; WARMAN and BECK: Cognitive Therapy Centre, Philadelphia.

Please send correspondence and reprint requests to: Douglas Turkington, MD, Department of Psychiatry, Royal Victoria Infirmary, Richardson Road, Newcastle-Upon-Tyne, Tyne And Wear, United Kingdom, NE1 4LP.

© 2004 Lippincott Williams & Wilkins, Inc.