Psychosis Sucks!

by Stars Training Academy   3 Comments

altered statePsychosis sucks – true that. Significant numbers of young people and their families seek help from mental health providers when they begin experiencing acute emotional distress along with disturbing thoughts and behaviors. They will often be diagnosed with a psychotic disorder or schizophrenia and prescribed psychotropic medications. If eligible, they may also be offered case-management services (help on getting housing, income, work), and a variety of psychosocial and psycho-educational supports. If lucky, they may also encounter Peer Mentors and access career development and educational assistance. A smaller percentage, will receive specific, evidence-based talk therapies that target their symptoms such as hearing voices, delusions and disorganized thinking.

Cognitive Behavioral Therapy for Psychosis (CBTp) is an evidence-based practice that has been extensively studied (see here and here) and is a recommended intervention in the U.K (in conjunction with psychotropics). CBTp has been found to be effective in helping people better manage their distress and improve functioning. A few, key precepts of CBTp are as follows;

  • Develop a collaborative relationship – expect both staff and client to take an active role in treatment. (Note: This is easy to say and can be very hard to do with many young people in the throes of psychosis and chaos – hang in there!)
  • Offer education and normalization – It’s important to “de-catastrophize” these alarming experiences, emphasize that mental illness/mental health is on a continuum, not an either/or proposition.
  • Help create a “shared story” or narrative formulation – One of the most essential tasks is making meaning by constructing a mutually agreed upon account of what happened/is happening with the youth. Use their language and descriptions and avoid psychological jargon and labeling.
  • Focus on reducing stress & enhancing adaptive coping – (not the reduction/removal of symptoms). Support the young person to develop practical strategies that will enable them to function at schools, work and community.

But above all, make sure to regularly nurture a sense of hope and a future vision with the youth. In her compelling TED talk, Eleanor Longden speaks eloquently of the providers who stood by her side at her darkest hours and let her know that her recovery was not only expected, but inevitable. Well worth watching – we all need to periodically rekindle our own sense of hope.

{ 3 comments… read them below or add one }

Karyn Dresser June 5, 2014 at 5:01 pm

Great practice tips, esp CBTp! Thanks for this blog!


Teisha Levi June 10, 2014 at 10:50 pm

This was a great blog to read especially working with clients who are diagnosed with a psychotic disorder. I’ve always favored CBT and to read about “CBTp” concepts puts things in a better perspective. Seems to include ‘structure’ and ‘direction’, which supports the therapeutic process.


Wayne Munchel, LCSW June 11, 2014 at 6:39 pm

Thanks for your comment, Teisha. I agree about CBTp providing some practical structure/direction to effectively responding to what can be very overwhelming situations w/ youth in crises.


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