Antipsychotic medications are the primary treatment for schizophrenia, but only 30% of patients are satisfied with their treatment during the first 18 months, and 20% to 30% experience treatment resistance. While antipsychotics are effective for positive symptoms, their impact on negative and cognitive symptoms is unclear. As a result, psychotherapy, including cognitive behavioral therapy for psychosis (CBTp), has become an important addition to treatment. CBTp, which emerged in the 1980s, incorporates psychosocial factors and has been used for managing positive and negative symptoms, but its effectiveness, particularly for negative symptoms, remains mixed.

CBTp aims to alleviate distress from psychotic symptoms rather than cure them, using techniques like cognitive restructuring and behavioral activation. For auditory hallucinations, CBTp focuses on elaboration of sounds and psychoeducation to help patients cope. Delusions are addressed through cognitive biases, and negative symptoms are managed with behavioral activation, social skills training, and cognitive restructuring. Although CBTp has shown promise, its effectiveness is still debated, especially for those with severe cognitive impairments or longer illness durations. Future studies should refine treatment protocols and examine long-term outcomes, tailoring interventions to neurocognitive levels and disease severity.

Reference: Kart A, Özdel K, Türkçapar MH. Cognitive Behavioral Therapy in Treatment of Schizophrenia. Noro Psikiyatr Ars. 2021;58(Suppl 1):S61-S65. doi: 10.29399/npa.27418.