Ten misconceptions about CBT for psychosis

Abstract CBT for psychosis is an established and evolving psychological therapy. Historical controversies about the nature of psychosis persist, and more recent debates about the outcome literature lack precision, muddying the waters further. Based on our experience as clinicians, teachers and supervisors, and following NHS and national lead roles, we describe ten common misconceptions about CBT for psychosis. These include misconceptions about the evidence, the focus of therapy, ‘thinking positively’, and the nature of collaboration and the therapeutic relationship. We refute these misconceptions based on current theory, research, and best practice guidelines. We highlight the need to get out of the clinic room, measure the impact of therapy on personal recovery and autonomy, and meet training and governance requirements. It is essential that clinicians, service leads, and our professional bodies uphold core standards of care if people with psychosis are to have access to high quality CBT of the standard we would be happy to see offered to our own family and friends. Key learning aims (1) To recognise common misconceptions about CBT for psychosis. (2) To counter these misconceptions theoretically and empirically – to inform ourselves, colleagues and service leads committed to ensuring high quality CBT for psychosis. (3) To highlight statutory and professional body responsibilities to ensure parity of esteem for people with psychosis, who deserve high quality, ‘full dose’ treatments delivered by appropriately trained clinicians, and supported by robust governance systems, just as we would expect for people with physical health conditions.