Cognitive behavioural therapy

What is cognitive behavioural therapy (CBT)?

CBT aims to generate links between patterns of thoughts, feelings, and behaviours using cognitive restructuring to facilitate the understanding and management of behaviours. It can be used for improving positive or negative symptoms, as well as other factors including depression, psychotic relapse and coping.

What is the evidence for CBT for people with schizophrenia?

Moderate to low quality evidence shows small improvements in global state with CBT in the long-term (>1 year), but not in the short-term (<6 months). There may also be some improvements in symptoms, but no consistent benefit was found for reducing relapse or rehospitalisation rates, or for improving overall functioning. There may be greater compliance with medication with CBT than with standard care.

Individually tailored CBT (rather than CBT guided by a standardised protocol) shows a medium-sized benefit from high quality evidence for reducing the severity of hallucinations when compared to standard care or supportive therapy. Moderate to high quality evidence finds a small benefit for improving delusion severity when compared to standard care, but not when compared to supportive therapy.

For people who are not responding well to medication, high quality evidence shows CBT improved positive and general symptoms compared to standard care. For people with a dual diagnosis of schizphrenia and a substance use disorder, moderate quality evidence finds CBT combined with motivational interviewing (but not CBT alone) can improve general life satisfaction; however, there were no additional benefits for improving quality of life, functioning, criminality, study retention, mental state or substance use.

May 2019

Last updated at: 4:22 am, 23rd May 2019
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Orange - Topic summary is being compiled.
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