The 10 psychological treatments for psychotic disorders

Psychotic disorders usually have psychopharmacology as their first-line treatment, being the antipsychotics the most used in these cases for the positive symptoms or psychotic symptoms of these disorders; however, psychotropic drugs have not shown much efficacy for the negative ones, so they need to be supplemented with psychological treatment.

Psychological treatments for psychotic disorders have been shown to be effective in treating negative symptoms of psychosis, with different treatments to work on social skills training, family therapies, psychoeducational interventions or cognitive rehabilitation, among other.

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.

• Related article: "The 8 types of Psychotic Disorders"

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 psychosis and their family members, regarding the available treatments and also to clarify issues associated with the psychosis.

These psychoeducational interventions also focus on providing people with psychotic disorders with strategies to learn to manage their disorder as much as possible, as well as other difficulties they may have as a result of their disorder so that may 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 preventing a lower likelihood 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 stages of a psychotic disorder, once detected and diagnosed, because they are beneficial for stabilization and to restructure the patient's environment, as well as for family members to understand in greater detail what is the mental disorder that your family member suffers from and can serve as support, so that they acquire the necessary resources and guidelines for the management of the disorder and the prevention of relapses

• You may be interested in: "What is schizophrenia? Symptoms and Treatments "

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.

2.1. Generic social skills training

This modality of training in social skills is usually carried out in a group format, following a behavioral orientation based on the social learning modelTherefore, the psychotherapist ensures that the patients are involved during the group sessions in the training of interpersonal skills.

The skills trained include the following: verbal and non-verbal communication, learning appropriate responses within a social context, assertiveness training, etc.

• Related article: "The 6 types of social skills, and what they are for"

2.2. Cognitive-behavioral social skills training

This treatment is known worldwide by its English name "Cognitive Behavioral and Social Skills Training" (CBSST) and their interventions use social skills training techniques similar to those used in classic generic models; However, this treatment stands out for the implementation of cognitive-behavioral techniques (p. g., cognitive restructuring, behavioral experiments, Socratic dialogue, etc.).

• You may be interested in: "Cognitive-Behavioral Therapy: what is it and on what principles is it based?"

23. Social skills training based on the UCLA-FAST model

This model of social skills training was implemented by the University of Los Angeles and it is made up of classic social skills training, which we can find in other models, together with intervention in psychoeducation, work in the prevention of relapses and training in skills for a good development in the activities of the daily life (p. g., taking medication correctly, working or even being able to live independently).

2.4. Cognitive-social skills training

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 What training skills in theory of mind or perception of emotions.

It should also be noted that this skills training allows working with computer programs or videos to facilitate the training social responses, while allowing the patient to repeat the process as many times as need.

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 disorders, as well as with the medication prescribed by a specialist for the positive symptoms of schizophrenia.

However, these interventions are showing promising results, so they could be a good cost-effective option for treating negative symptoms of psychotic disorders within mental health systems, such as within the public health system where, due to lack of means and sufficient personnel, As the small number of psychologists present in the different hospitals, training in social skills could be a good alternative to work in a group.

3. Family therapies for psychotic disorders

Psychological treatments for psychotic disorders include family therapies and, as discussed above, the support of the patient's family is essential in order for there to be a better prognosis.

Within family therapies for psychosis, there are several alternatives, so normally it will be the patient and her family members who decide what modality of family intervention prefer. Among the options that there are, the following should be highlighted:

• Single or multi-family interventions.
• Family interventions in which the family member who suffers from the psychotic disorder is or is not.
• That they are guided by a member of the clinical team and serve as a link with the team, or with the team on the sidelines.
• Focused solely on psychoeducation, including cognitive treatment or other psychotherapy modalities.

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 one of the interventions most studied for the treatment of psychotic disorders and have shown high validity empirical.

• Related article: "Family therapy: types and forms of application"

4. Cognitive-behavioral therapy for psychotic disorders

Within the psychological treatments for psychotic disorders, one of the most used is cognitive-behavioral therapy, given its proven efficacy for numerous disorders mental.

Cognitive behavioral therapy for psychosis focuses primarily on two aspects: help the patient and her relatives to understand the disorder and the positive symptoms of psychosis and, on the other hand, in the work of the cognitive schemata of the patient who are very likely to interfere in the emotional disorder that a person with a psychotic disorder usually suffers.

5. Cognitive therapy to treat hallucinations and delusions

Another psychological treatment for psychotic disorders is "belief modification therapy" whose objectives fundamental are two types of interventions (verbal challenge and reality test) through restructuring cognitive.

The verbal challenge It consists in providing help to the patient with psychosis to modify the content of her distorted beliefs. For this, the psychologist must use a position that is not confrontational, so that the patient's beliefs are gradually graduated.

The reality check It is used in order to verify the delusional belief of the patient through an empirical test that serves to refute with confirming that belief.

These two techniques are often used together; In addition, it has been proven that the reality test alone is not effective, while if it is preceded by the technique Verbal challenge is effective, the latter having proven to be the most effective component of the treatment.

• You may be interested in: "Hallucinations: definition, causes, and symptoms"

6. Psychological treatments for next-generation psychotic disorders

Two innovative psychological treatments for psychotic disorders will be briefly explained below.

6.1. AVATAR therapy

It is a novel psychological therapy whose main objective is to help reduce discomfort and the frequency with which they appear 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 by computer software of the entity that the patient believes is speaking). This software has been programmed to transform the voice of the psychologist and achieve the same timbre and tone of time that the patient hears in his head.

Within this therapy It is intended that the patient can interact with the voice he hears in his head and that he is thus 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 a relational and dialectical approach in order to work on the relationship with negative content auditory hallucinations. On the other hand, this therapy does not directly seek to make the voices disappear in his head, but rather focuses on working on the relationship of the patient with the voices that appear in his mind in order to strengthen the sense of control over the voices by the patient.

At the moment, two clinical studies have been carried out with good short-term results, although there is still more research, as not enough long-term evidence has 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 from the model known as “Moderated On-Line Social Therapy” (MOST) and it is a model of interventions psychological interventions through the Internet that takes advantage of technology to expand traditional psychosocial interventions to a greater number of persons. 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 shown through a study carried out very promising results, since online intervention can be of great help, due to its easy access, for young people who have suffered a first episode psychotic In addition, the study observed that there were few dropouts and a high degree of satisfaction among patients and already a controlled clinical study is underway that will last five years in order to study its long-term efficacy term.