CBT for Psychosis (CBTp): Therapy Course Module 6

What the module teaches

Module 6 of the PsychoPharmRef therapy course covers cognitive behavioral therapy for psychosis (CBTp) and related approaches for schizophrenia. Its stance is collaborative and normalizing: the aim is to reduce the distress and disruption caused by psychotic experiences, not to argue that a voice or belief is false. The Learn tab walks through ten topics:

• Engagement and normalizing as the foundation of the work
• Assessment and collaborative formulation (the ABC model and the 4 Ps)
• Working with distressing voices, with a focus on beliefs about the voice's power and control
• Working with distressing beliefs: conviction ratings, evidence, alternative explanations, and behavioral experiments
• Negative symptoms and functioning, using behavioral-activation logic
• Course and format, including the NICE recommendation of at least 16 planned sessions
• Family intervention, social skills training, and cognitive remediation
• Integration with medication, crisis planning, and managing engagement and therapist reactions

Sections and worksheets

Five interactive tabs follow the Learn tab. Formulate builds an ABC map and a 4 Ps longitudinal formulation. Voices records content, triggers, and 0–100 ratings of the voice's power, the person's control, and pressure to comply, with a coping-strategy checklist. Beliefs rates conviction and distress, lists evidence for and against, and plans a behavioral experiment. Goals sets a SMART functioning goal, reframes defeatist beliefs, and scales it with Goal Attainment Scaling. Outcomes and Staying Well logs a target rating per session with change from baseline and builds a written staying-well and crisis plan. Each worksheet copies to plain text, and blank worksheets are available as a PDF.

Who it is for

The module is aimed at trainees and advanced students and takes about 5–7 contact hours. It is a teaching module for supervised skill development. The worksheets are practice aids, not validated instruments. When psychotic symptoms involve risk, such as command hallucinations or persecutory beliefs driving action, the module directs clinicians to prioritize risk assessment, safety planning, and coordination with the treating team. CBTp is presented as a complement to antipsychotic medication, not a replacement.

Sources

The module draws on NICE guideline CG178 (psychosis and schizophrenia in adults), Landa's VA introductory CBTp manual, Kingdon and Turkington's Cognitive Therapy of Schizophrenia, Morrison and colleagues' cognitive therapy work, and Wykes and Reeder on cognitive remediation.