Cognitive Behavioural Therapy for psychosis (CBTp) — techniques, evidence, and how it helps.
Built from a systematic review of 87 papers, CHIME captures the five processes most people in recovery describe: connectedness, hope, identity, meaning, and empowerment.
TherapyDialectical Behavior Therapy was originally designed for chronic suicidality and borderline personality disorder. In the past decade, adapted versions have moved into schizophrenia care — and the early evidence is encouraging.
CopingGrounding doesn't make psychosis disappear, but it gives you a foothold. Here is a clinician-informed toolkit you can practise on calm days and reach for on hard ones.
TherapyFamily psychoeducation has decades of evidence showing it cuts relapse rates roughly in half. It's also one of the least delivered interventions in US mental health care.
RecoveryWRAP gives people a structured way to write down what keeps them well, what tips them off-balance, and what to do when things get hard. SAMHSA lists it as an evidence-based practice.
TherapyMotivational interviewing started in addictions but has become a core skill for working with schizophrenia — especially around medication adherence, substance use, and engagement.
TherapyAcceptance and Commitment Therapy invites people to make room for difficult inner experiences and to keep moving toward what matters. For psychosis, this means a different relationship with voices, urges, and beliefs.
CopingThe 5-4-3-2-1 technique is one of the most widely taught grounding skills. Here is how to adapt it for schizophrenia, including which steps to modify if a step backfires.
TherapyDBT was built for borderline personality disorder, but its concrete skills — mindfulness, distress tolerance, emotion regulation — are increasingly adapted for psychosis.
RecoveryIn 2012 SAMHSA released a working definition of recovery that has become the official US framework: a process of change across four dimensions — health, home, purpose, and community.
CopingDistraction is one of the oldest and most effective ways to take the edge off distressing voices. Here are the techniques with the best evidence and how to use them well.
TherapyWorking with delusions in CBT does not mean trying to talk someone out of a belief. It means building trust, exploring meaning, and gently widening the range of possible explanations.
TherapyMindfulness has moved from monasteries into mainstream mental health. For psychosis, it can be powerful — but it needs careful adaptation, and it is not safe in every form for every person.
TherapyOpen Dialogue is a Finnish approach to first-episode psychosis built around rapid family meetings, minimal medication, and treating the network rather than the individual.
CopingReality testing is a core CBTp technique for working with strong beliefs that don't match what other people see. Done well, it is curious — never combative.
TherapyNegative symptoms — apathy, low motivation, blunted emotion — drive much of the long-term disability in schizophrenia. CBT cannot eliminate them, but it can reliably move the needle.
RecoveryThe recovery movement and the psychiatric survivor movement share roots in lived experience but ask different questions. Understanding both helps people choose what frameworks fit their lives.
TherapyMany people with psychosis carry years of shame and self-criticism. Compassion-Focused Therapy directly addresses those emotional drivers and has shown promising results in voices and paranoia.
TherapyLong before Open Dialogue, Finnish psychiatrist Yrjö Alanen built Need-Adapted Treatment — a flexible model that treats every first episode of psychosis as unique.
CopingWhen you are distressed, you cannot remember everything you know. Coping cards put your best advice to yourself in your pocket — short, clear, and ready when you need them.
TherapyMost people with psychosis have a trauma history, and many also meet criteria for PTSD. For decades, clinicians worried trauma therapy might destabilise. The newer evidence is reassuring.
TherapyStarted in the Netherlands in the 1980s, the Hearing Voices Network treats voices as meaningful experiences worth engaging with — not only as symptoms to suppress.
TherapyThe CBT for psychosis literature is large, contested, and sometimes oversold. Here is a fair-minded summary of what the trials actually show, and what they do not.
RecoveryMary Ellen Copeland began her work after her own breakdown left her unable to find practical guidance on living well with serious mental illness. WRAP grew from that gap.
Therapy modalitiesWRAP turned the question of mental health recovery into a writing exercise. The five key concepts — hope, personal responsibility, education, self-advocacy, and support — sit underneath six sections that any person can fill out, with or without a clinician.
CopingA sensory toolbox is a physical kit of small items chosen to ground you through your senses. Built well, it sits on a shelf and waits for hard moments without judgement.
TherapyTrauma is far more common in people with schizophrenia than in the general population — and standard psychiatric care can sometimes retraumatise. Trauma-informed care is the alternative.
TherapyAsking whether CBT can replace antipsychotics frames the problem badly. The real question is which combination, in what sequence, for which person.
TherapyEye Movement Desensitisation and Reprocessing has moved from the margins of trauma care to the mainstream. For people with psychosis and PTSD, the evidence now supports its use.
Expressive therapiesExpressive writing is one of the simplest and most studied self-help interventions in psychology. In schizophrenia, it can be useful — with some care about timing, content, and pacing.