The 10 Psychological Treatments For Psychotic Disorders
Psychotic disorders normally have psychopharmacology as their first-choice treatment, with antipsychotics being the most used in these cases for the positive symptoms or psychotic symptoms of these disorders; However, psychotropic drugs have not proven very effective for negative ones, so they need to be complemented with psychological treatment.
Psychological treatments for psychotic disorders have demonstrated their effectiveness in treating the negative symptoms of psychosis, with different treatments available to work on social skills training, family therapies, psychoeducational interventions or cognitive rehabilitation, among others.
In this article we will briefly look at some of psychological treatments for psychotic disorders that are most used in the field of clinical psychology.
1. Psychoeducational interventions for psychotic disorders
Before explaining the psychological treatments for psychotic disorders, it is worth highlighting the psychoeducational interventions that are carried out in order to provide important information to the population and, especially to people who suffer from some type of psychosis and their families, regarding the available treatments and also to clarify issues associated with psychosis.
These psychoeducational interventions also focus on providing people with psychotic disorders with strategies to learn to manage their disorder to the extent possible, as well as other difficulties they may have as a result of their disorder so that they can have a normal life. Likewise, psychoeducational interventions are frequently used in order to improve adherence to some of the psychological treatments for psychotic disorders, as well as to prevent a lower probability of relapses.
Psychoeducational interventions can be carried out in various formats: individual, group, family, etc.) and usually have an average of 12 sessions, although shorter interventions of 10 sessions have also been found with good results.
Notably Family psychoeducational interventions for psychotic disorders are essential during the early phases of a psychotic disorderonce detected and diagnosed, because they are beneficial for stabilization and restructuring the patient’s environment, as well as for family members to understand in greater detail what the mental disorder that their family member suffers consists of and can serve as support, so that they acquire the necessary resources and guidelines for managing the disorder and preventing relapses.
2. Social skills training for psychotic disorders
There are various psychological treatments for psychotic disorders based on training the patient’s social skills; For this reason, we will highlight the best known ones below.
This type of social skills training is usually carried out in a group format, following a behavioral orientation based on the social learning modelso the psychotherapist ensures that patients get involved in the training of interpersonal skills during the group sessions.
Among the skills trained, the following should be highlighted: verbal and non-verbal communication, learning appropriate responses within a social context, assertiveness training, etc.
2.2. Cognitive-behavioral social skills training
This treatment is known worldwide by its English name “Cognitive Behavioral and Social Skills Training” (CBSST) and In its interventions, social skills training techniques similar to those used in classic generic models are used.; However, this treatment stands out for the implementation of cognitive-behavioral techniques (e.g., cognitive restructuring, behavioral experiments, Socratic dialogue, etc.).
23. Social skills training based on the UCLA-FAST model
This social skills training model was implemented by the University of Los Angeles and is composed of classic social skills training, which we can find in other models, along with intervention in psychoeducation, work on relapse prevention and training in skills for good performance in activities of daily living ( (e.g., taking medication correctly, working, or even being able to live independently).
2.4. Training of cognitive-social skills
This treatment has been called by its creators as “Social Cognitive Skills Training” (SCST) and was developed based on work with the cognitive-social processes of patients with psychotic disorders such as training theory of mind skills or emotion perception.
It should also be noted that this skills training allows working with computer programs or videos to facilitate the training of social responses, while allowing the patient to repeat the process as many times as needed.
As we can see, there are multiple modalities of training in social skills; However, there are specialized guides on the evidence of psychological treatments that recommend that social skills training is not the only option, but should be complemented with other treatments for psychotic disordersas well as with medication prescribed by a specialist for the positive symptoms of schizophrenia.
However, these interventions are showing promising results, so they could be a good option in terms of cost-effectiveness to treat the negative symptoms of psychotic disorders within mental health systems, such as within the public health system. where, due to lack of resources and sufficient personnel, such as the small number of psychologists present in the different hospitals, training in social skills could be a good alternative to working in groups.
Psychological treatments for psychotic disorders include family therapies and, as already mentioned, The support of the patient’s family is essential in order to have a better prognosis..
Within family therapies for psychosis, there are several alternatives, so it will normally be the patient and their relatives who decide which modality of family intervention they prefer. Among the options available, the following stand out:
This type of psychological treatments for psychosis They usually last between 3 and 7 months.having at least 10 sessions as a minimum.
It is important to highlight that psychological interventions in a family format are among the most studied interventions for the treatment of psychotic disorders and have demonstrated high empirical validity.
Related article: “Family therapy: types and forms of application”
4. Cognitive behavioral therapy for psychotic disorders
Among psychological treatments for psychotic disorders, one of the most used options is cognitive-behavioral therapy, given its proven effectiveness for numerous mental disorders.
Cognitive behavioral therapy for psychosis focuses fundamentally on two aspects: help the patient and their family understand the disorder and the positive symptoms of psychosis and, on the other hand, in the work of cognitive schemes of the patient that is very likely to interfere with the emotional disorder that a person with a psychotic disorder usually suffers from.
5. Cognitive therapy to treat hallucinations and delusions
Another psychological treatment for psychotic disorders is “belief modification therapy” whose fundamental objectives are two types of interventions (verbal challenge and reality testing) through cognitive restructuring.
The verbal challenge It consists of providing help to the patient with psychosis to modify the content of their distorted beliefs. To do this, the psychologist must use a position that is not confrontational, so that the patient’s beliefs are gradually graduated.
The reality test It is used in order to verify the patient’s delusional belief through an empirical test that serves to refute and confirm that belief.
These two techniques are often used together; Furthermore, it has been proven that the reality test alone is not effective, while if it is preceded by the verbal challenge technique it is effective, the latter having proven to be the most effective component of the treatment.
You may be interested: “Hallucinations: definition, causes, and symptoms”
6. State-of-the-art psychological treatments for psychotic disorders
Two innovative psychological treatments for psychotic disorders will be briefly explained below.
6.1. AVATAR therapy
It is a new psychological therapy whose main objective is to help reduce discomfort and the frequency with which it appears. verbal hallucinations that resist antipsychotic medication in patients suffering from psychotic disorders.
During the sessions of this therapy, a three-way interaction is carried out (between the psychologist, the patient and a representation through computer software of the entity that the patient believes is speaking to him). This software has been programmed to transform the psychologist’s voice and achieve the same timbre and tone that the patient hears in his or her head.
Within this therapy The aim is for the patient to be able to interact with the voice they hear in their head. and thus be able to face the negative and pejorative comments that he hears in his head with the aim of modifying his relationship with them and thus paying less attention to them.
This innovative therapeutic modality has adopted the relational and dialectical approach in order to work on the relationship with auditory hallucinations of negative content. On the other hand, this therapy does not directly seek to make the voices in the head disappear, but rather focuses on working on the patient’s relationship with the voices that appear in their mind in order to strengthen the feeling of control over the voices through part of the patient.
At the moment, two clinical studies have been carried out with good short-term results, although there is still more research to be done, since sufficient long-term evidence has not been found.
6.2. The HORYZONS project
This project was developed in order to facilitate access to psychological treatments for psychotic disorders for young people. This project has been created based on the model known as “Moderated On-Line Social Therapy” (MOST) and is a model of psychological interventions through the Internet that takes advantage of technology to expand traditional psychosocial interventions to a greater number of people. people. To do this, it uses an online platform that provides access to various psychosocial interventions with the help of psychologists.
The HORYZONS project, despite being quite recent, has demonstrated very promising results through a study, since the online intervention can be of great help, due to its easy access, for young people who have suffered a first psychotic episode. In addition, the study observed that there were few dropouts and a high degree of satisfaction among patients and a controlled clinical study that will last five years is already underway in order to study its long-term effectiveness.
