CBT for Psychosis: A Symptom-Based Approach

This is an ambitious book that brings together the clinical and research experience of a wide range of international leading experts, mainly European, on the field of hallucinations. Its main aim is to provide an insightful understanding of these multifaceted experiences and to offer a practical guide to their assessment and treatment in day-to-day clinical practice. For this, the book has a practical orientation, focusing on the available intervention strategies, mainly psychological, and evaluation methods, incorporating when needed clinical vignettes and case samples. The treatment and evaluation protocols proposed are backed up by empirical evidence of their efficacy. From a general perspective of analysis, the book has two main conceptual problems in its structure. The first one is its almost exclusive focus on a psychological perspective. Although this is understandable from a research point of view, the case is that in day-to-day clinical practice the main strategies of intervention are biological. This one-sided orientation is compounded by the absence of reference to an integrated (biological and psychological) model of treatment in the chapters devoted to psychological interventions. This is revealing, as in today’s clinical practice very rarely are these interventions used in isolation for the treatment of hallucinations. The second problem is the lack of a conceptual framework to integrate the many different intervention strategies described. Despite these limitations, the book covers a wide spectrum of interventions, ranging from the biological to the psychosocial polarity. At the biological end it includes a very good and comprehensive chapter on the pharmacological treatment of hallucinations, and also a chapter concerning the emerging use of transcranial magnetic stimulation in hallucinations. But where the book is particularly strong is in discussing the psychosocial perspective, with numerous types of psychological interventions, at both the individual and group level. Of special interest are the chapters dedicated to cognitive-behavioural therapy, attention training technique, acceptance and commitment therapy, competitive memory training, hallucinations-focused integrative therapy, and coping strategies to reduce the negative impact that hallucinations have on patients. In addition, it also incorporates comprehensive chapters dedicated to a particular type of verbal hallucinations, ‘command hallucinations’, and also to hallucinations in the context of particular clinical situations. Finally, the book ends with a comprehensive chapter on the assessment of hallucinations. In summary, this book makes available very extensive, updated and useful information for the evaluation and treatment of hallucinations, focusing mainly on the psychological strategies of treatment. The information provided is very clear and practical and should be of great utility for practising clinicians.