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Cognitive Therapy for Treatment of Psychosis: Choosing the Right Provider



Often when young people and their families visit Laurel House, the top question on their minds is how a “psychiatric rehabilitation” program like ours can help people with serious mental illness have a better life. The concept of mental health rehabilitation can be hard to understand at first. But people usually get it when we tell them about Thinking Well, a cognitive therapy program that uses the Neuropsychological Educational Approach to Cognitive Remediation (NEAR).

Key Points from Part 1 in this series:
Cognitive therapy is a time-limited, results-oriented approach that is most effective when there’s a specific problem or goal to work on.
Cognitive Remediation (CR) uses individualized drills and group bridging sessions to improve functioning in targeted areas of cognition such as attention, memory, and problem-solving.
Cognitive Behavior Therapy (CBT) is a form of psychotherapy that helps people understand how their thoughts influence their feelings and behavior.

One reason the Thinking Well program is so attractive to clients of Laurel House and their families is that its results-oriented approach offers hope that recovery is possible. All true cognitive therapies share this approach: they focus on learning and building thinking skills that people can use to achieve their goals in life. For many people living with schizophrenia and other serious mental health disorders, cognitive therapy can be life-changing. This is why choosing the right provider is so important.

3 Things to Look for in a Provider of Cognitive Therapy

Results — Cognitive therapy focuses on solutions to specific problems. Therefore, results should be measurable. You can usually determine this by asking, “Is the therapy designed to improve or solve a problem?” Examples: overcoming a fear of crowded spaces through CBT; measuring gains in memory, attention, and problem-solving with cognitive testing in a CR program.

Integrated Services – Cognitive therapy is most effective when used in combination with other best practices such as CBT and psychopharmacology, or CR and supported employment. Active symptoms of psychosis (hallucinations or delusions), can make it hard to benefit from either approach. A person with schizophrenia should seek treatment for those symptoms prior to entering any form of cognitive therapy. Treatment and services provided in a coordinated, integrated fashion are generally more effective than those that are not.

Diagnosis – When it comes to diagnoses, one size does not fit all. Many cognitive therapists specialize in the treatment of specific disorders such as depression or anxiety. If you have a problem with psychosis, you should look for a provider who is experienced in the treatment of schizophrenia and related disorders. Some methods of cognitive therapy such as the NEAR model of CR were developed specifically for the purposes of treating people who experience psychosis.

Two Questions You Can Ask to Evaluate a Provider

What is your background and training in cognitive therapy? With cognitive therapy’s reputation for getting results, it seems that every other therapist on the Web now lists a specialty in CBT. But CBT, like CR, is an advanced, highly specialized skill that takes years to learn and practice well. Providers who offer it should be able to tell you where they trained, in what model, under what licensing or certifications they practice, and how long they have been doing it.

How will this therapy benefit me or my loved one? Listen for specific results-oriented answers. Most cognitive therapy is meant to be time-limited and solution-focused. Look for answers like: “During this 30-session course in CR we will focus on improving your attention, working memory, and problem-solving skills to help you succeed in college.” “In CBT sessions with your son I will work with him to examine and reconsider the false beliefs that interfere with his daily living. The process is usually longer for someone with schizophrenia, so this could take a year or more.”

Come back next week for the final installment in this 4-part series: Evaluating the Success of Cognitive Therapy in Yourself or a Loved One. Be sure to catch up on Part 1 and Part 2 in this series.

If you think you or someone you know might benefit from cognitive therapy, it is important to seek help from a qualified mental health professional. Our Resource Specialist can help you find expert mental health resources to recover in your community. Contact us now for more information on this free service to our users.

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Jay Boll, Editor in Chief www.rtor.org

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