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Cognitive Behavioral Therapy (CBT)
The Schizophrenia Program of the MGH offers cognitive behavioral therapy for individuals with first episode or early psychosis as part of routine treatment. CBT is also offered to individuals who are interested in participating in CBT research and who are determined to be eligible for current studies.
CBT stands for cognitive behavioral therapy. It is a systematic psychological treatment that was originally developed for depression. CBT is now used to treat a variety of other conditions and is generally considered one of the first line treatments for anxiety and depression. In recent years, CBT has become recognized as a promising psychosocial treatment in schizophrenia. Researchers in the United Kingdom and abroad have identified CBT as significantly reducing distress, psychotic symptoms, and negative symptoms for individuals diagnosed with schizophrenia and other psychotic disorders. As a result of the positive results found with CBT in other countries, a panel of experts in the United States have recently recommended CBT be considered a component of state-of-the-art treatment for schizophrenia.
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What are the goals of CBT?
The main assumption of CBT is that psychological distress often develops and is maintained by dysfunctional patterns of thinking and behavior. CBT works to alleviate distress by modifying problematic patterns of thinking and optimizing productive behaviors. CBT seeks to improve an individual's ability to function despite difficult symptoms or experiences.
Frequently Asked Questions
I want to go back to work/school. Will CBT take too much of my time?
Although CBT involves making a time commitment (usually one or two 50-minute sessions per week for 6 months), most people find that this investment of time is very worthwhile. The main focus of CBT is to help you to identify personal goals (which often include school and career-oriented goals) and to develop the tools to reach these goals. Many people use CBT to help improve their lives after their goals were interrupted by symptoms or hospitalization.
I am feeling a lot better now that I am out of the hospital—I don’t think I really have schizophrenia—I think that my difficulties were just caused by stress.
Many people who participate in CBT are unsure about their diagnosis—a CBT therapist can help you to figure out what has happened, how to deal with the disruption in your life caused by symptoms, and how to begin to get your life back on track.
I don’t want to take medication—Can I still do CBT?
CBT is a treatment that can be used alone or together with psychiatric medications. Some conditions are best treated with a combination of medication and CBT. Medication can sometimes significantly decrease anxiety and improve thinking and concentration which makes it easier to participate in and benefit from CBT. If you are feeling unsure about whether or not you want to take medication, a CBT therapist can help you to evaluate the advantages and disadvantages of medication. CBT strategies can also be used to help develop ways to cope better with side effects of medication and to improve communication between you and your doctor about medication-related issues.
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