Living with psychosis can make the world around you seem confusing, scary, and difficult to trust. You might hear or see things that others don’t. You might believe that something dangerous is happening or feel paranoid about what’s real and what’s not. While these feelings can be scary and overwhelming, treatment is possible.Â
Cognitive behavioral therapy for psychosis (CBTp) is a structured therapy that can help you understand psychotic symptoms. It can help lessen distress, teach you skills to cope, and allow you to work through your thoughts, emotions, and responses in a safe environment.[1][2][3] On this page, we will discuss:Â
CBT for psychosis (sometimes shortened to CBTp) is a form of talk therapy for people who are experiencing psychosis. Symptoms of psychosis may include hallucinations, delusions, paranoia, disorganized thinking, or disconnection from reality.[4][5]
Psychosis can occur with:[4][5]
When you experience psychosis, you may feel misunderstood by others, judged for your experiences, or scared to be open about what is happening. CBTp can help elicit different feelings. The therapist will help you understand how your thoughts, emotions, body sensations, and behaviors relate to the distress you are experiencing.[2][3] You might have learned that sharing your symptoms upsets your family or leads to treatment that you don’t like.
Severe psychosis treatment takes into account what you’re experiencing. Say, for example, you hear a voice threatening to harm you. It makes sense that you might feel scared, avoid being around others, and not want to leave your home. That’s a logical response to being threatened.
CBTp can help to identify what causes the voice to intensify, what can be done to feel safer, and how to react in a way that allows you to feel more in control.[2][6]
Recovery from psychosis is possible, but it doesn’t always mean symptoms disappear entirely. It often means:[1][4]Â
CBTp will look different for everyone. But in many cases, treatment begins with building trust. A therapist wants to hear what you have to say and to understand what you’re experiencing. This step is vital because feeling safe in psychosis therapy is essential.[2] If someone feels blamed, pressured, or dismissed by their therapist, they may become defensive and suspicious.
If you’ve had bad experiences with mental health treatment before, if you’ve been forced into care or felt unheard, building trust may take longer. That’s normal, and a good therapist won’t rush you. Once trust is established, a therapist may ask questions about:
You and your therapist can work together to identify possible triggers or things that make symptoms worse. This is also called formulation. It means creating an individualized roadmap for how psychosis affects your life.[2]
CBTp can help you:[1][2][3][4]
CBTp is typically combined with other forms of care or is part of a full mental health treatment program. It may be paired with:[1][4]Â
CBTp can help you cope with hallucinations, especially when they feel frightening, controlling, or disruptive. Therapy may help to make sense of the experience and lessen the distress that comes with it.[2][3][6]
Hallucinations can be hearing, seeing, feeling, smelling, or tasting something that others don’t perceive.[5] Hearing voices is one common type of hallucination.[5] These voices may be critical or threatening, and may command you to do certain things. Other hallucinations may be confusing, distracting, or emotionally draining.
During treatment, a therapist can help you to discover:
Developing tools and coping techniques can help you feel less trapped by the hallucination. Coping skills taught in CBTp include:[2][6]
These will not address the causes of the hallucinations, but they can help you manage them while treatment is ongoing.
A delusion is an unshakable belief that goes against what most people understand about reality.[5] To someone who is experiencing delusions, the thought may feel undeniably true.
Your therapist can help you notice how much the belief is distressing you, and how it’s affecting your:[2][6]Â
If you believe people are following you, your therapist may help you notice when that thought becomes stronger. Does it begin to creep in after a night of restless sleep? Does it get worse when you’re around lots of people? These patterns help you understand what makes the belief louder or quieter.
Psychosis therapy can help you:[2][6]Â
Therapy for hallucinations can help you make sense of the experience and feel less distressed.[2][6] The beliefs that feel real to you can begin to feel less convincing or overwhelming, so you have better control over your response.
Schizophrenia affects how you:[4][5]Â
For this reason, schizophrenia therapy often addresses more than hallucinations or delusions. It might address motivation, social withdrawal, difficulty concentrating, or trouble with daily tasks. These symptoms can be just as disabling as hallucinations, but don’t get the same attention.
Psychotic disorder treatment looks different for everyone depending on individual needs, but can include:[1][4]Â
CBTp can be one component of a larger treatment plan, helping you understand your symptoms, cope with distress, and restore parts of life that have become unmanageable because of psychosis.[1][4]
CBT for psychosis can also help you cope with the fear or uncertainty you have about psychosis, and with residual shame, avoidance, lack of motivation, or trust. Many people with psychosis have experienced stigma or trauma related to their symptoms or their treatment. Therapy can help with that, too.
You can recover from psychosis.[1][4] Someone who is recovering from psychosis often has:[1][4]Â
AMFM is here to help you or your loved one take the next steps towards an improved mental well-being.
Cognitive behavioral therapy sessions for psychosis are structured like guided conversations. Topics that come up may include recent symptoms, questions about medication, or personal goals for daily life. Your therapist can help you to observe patterns of behavior without becoming solely focused on them.[2] The aim is to notice what’s connected to what, so you can make different choices when it matters.
For example, you may recognize that the voices become louder after you get into an argument. Maybe paranoia increases when you haven’t slept. Or maybe it is hard to question paranoid thoughts when you are under stress. Once you notice a pattern, you can work on the thing that’s making symptoms worse.Â
CBTp uses:[2]Â
Behavioral experiments are used to gather information in a safe, supportive way. If you’re worried about leaving your house, your therapist can help you take one small step outside with support. You then process what did or didn’t happen and see whether your thought patterns and worries were accurate.[2][3]
CBTp incorporates some of the same tools as standard CBT. The main difference is that CBTp is often slower.Â
When you are experiencing psychosis, you may have fears that feel like:[2]Â
CBT must be modified to take these experiences into account. This involves patience, trust, and a therapist who understands your experiences.[2]
The therapist will work with you to minimize fear and suffering. Instead of trying to reason you out of the symptoms, they will try to build space between the experience and your response.[2][6]
CBTp is often used alongside medication.[1][4] Antipsychotic medication can make it easier to manage hallucinations/delusions, severe disorganization, or agitation.[1][4] Many people need medication but still experience psychotic symptoms. Others have concerns about side effects, fear of treatment, or what it takes to stay consistent with care.
CBTp provides a safe space to discuss those concerns and make informed medication decisions with a treatment team. This approach can help build evidence, confidence, skills, and stability at a pace that feels comfortable.[2][3]
When symptoms are too severe to be managed with weekly outpatient therapy alone, residential psychosis treatment may be needed. Residential treatment may be appropriate when:[1][4][5]
At a psychosis treatment center or residential mental health treatment program, you can receive structure, psychiatric care, therapy, medication management, stabilization, and help with creating a plan to prevent future relapses.[1][4]
A Mission For Michael (AMFM) provides treatment for adults experiencing various conditions. Psychosis support is a phone call away – call 866-478-4383 to learn about our current treatment options.
See our residences in Southern California’s Orange County & San Diego County.
Take a look at our homes on the east side of the Metro area in Washington County.
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Psychosis can be scary, isolating, and draining. It can also be hard for those closest to you to understand what is going on or how they can help. However, psychosis can be treated, and you’re not alone.
AMFM (A Mission For Michael) Mental Health Treatment offers treatment for psychosis, schizophrenia spectrum symptoms, mood disorders, trauma, anxiety, depression, and other mental health concerns that have unique and complex needs. Treatment will vary based on your needs but may include individual therapy, psychiatric services, group therapy, family resources, coping skills training, and a structured mental health program.
CBT for psychosis can help you gain a better understanding of what you’re experiencing and react and respond with stability and confidence. Our team of expert clinicians believes in treatment persistence and will personalize your treatment plan so you can achieve lasting, life-changing outcomes.
Our locations in California, Minnesota, and Virginia accept insurance and are in-network with most major providers. To check your insurance coverage for mental health care, simply complete our confidential online verification form or call us now at 866-478-4383.
If you or someone you love is experiencing hallucinations, delusions, paranoia, or intense emotional distress, we can help you take that next step toward getting support. Our compassionate team is available 24/7 to answer your questions and provide guidance with no obligation.
Reach out to us today to start the admissions process or learn more about how we can support your mental well-being.Â
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