BeST Center

Cognitive Behavioral Therapy for Psychosis (CBT-p) Resources




“Stepped Care as an Implementation and Service Delivery Model for Cognitive Behavioral Therapy for Psychosis” by Sarah L. Kopelovich, Eric Strachan, Harry Sivec and Valerie Kreider, Community Mental Health Journal, January 2019.

Cognitive behavioral therapy for schizophrenia spectrum disorders is an evidence-based treatment that is recommended by United States schizophrenia treatment guidelines. Based on recent estimates, only 0.3% of individuals with a primary psychotic disorder are able to access this treatment in the United States. Stepped care interventions have shown promise as an applied treatment delivery model in other settings and for other psychotherapeutic interventions. This paper describes how the stepped care model can be applied to CBT for psychosis in the U.S. to increase access to the intervention in community mental health settings by leveraging the multidisciplinary team.

Cognitive Behavioral Therapy for Psychosis (CBT-p) Delivered in a Community Mental Health Setting: A Case Comparison of Clients Receiving CBT Informed Strategies by Case Managers Prior to Therapy. by H.J. Sivec, V.L. Montesano, D.A. Skubby, K.A. Knepp and M.R. Munetz. Community Mental Health Journal, 2017.

This exploratory case comparison examines the influence of case management activities on engagement and progress in psychotherapy for clients with schizophrenia. Six clients were recruited to participate in ten sessions of Cognitive Behavioral Therapy for psychosis (CBT-p). Three clients who had received Cognitive Behavioral techniques for psychosis (CBt-p, a low-intensity case management intervention) prior to receiving therapy were selected from referrals. A comparison group of three clients who had received standard case management services was selected from referrals. Cases within and across groups were compared on outcome measures and observations from case review were offered to inform future research. Delivering CBT-p services on a continuum from low- to high-intensity is discussed.

Adapting Cognitive Behavioral Therapy for Psychosis for Case Managers: Increasing Access to Services in a Community Mental Health Agency.  by V.L. Montesano, H.J. Sivec, M. R. Munetz, J.R. Pelton and D. Turkington, Psychiatric Rehabilitation Journal, January 27, 2014.

The purpose of this article is twofold: (a) to describe the adaptation of an evidence-based practice and, (b) to use a dissemination framework, to describe the process of implementing the practice at a community mental health agency. The authors describe the training concept and dissemination framework of implementing an emerging practice: high-yield cognitive behavioral techniques for psychosis, which is rooted in cognitive behavioral therapy. Thirteen case managers who represented teams from across the agency delivered the adapted practice at a community mental health agency. Implementation required buy in from all stakeholders, communication across disciplines, persistence, and flexibility. It appears that the use of a dissemination framework that is grounded in the literature, yet flexible, eases the process of implementing an adapted practice. Further research focusing on the effectiveness of this approach, along with the impact of implementing a full spectrum of cognitive behavioral therapy services for individuals with persistent psychotic symptoms, based on cognitive behavioral therapy principles, is indicated.

Clinical Process Examples of Cognitive Behavioral Therapy for Psychosis, by Harry J. Sivec and Vicki L. Montesano, 2013, Psychotherapy, 50(3)

Interest in the practice of Cognitive Behavioral Therapy for persistent psychotic symptoms (CBT-p) has increased dramatically in the last decade. Despite the widespread interest, it remains challenging to obtain adequate training in this approach in the United States. This article provides a few hypothetical examples of the types of interventions commonly used in CBT-p. We provide information about the theoretical basis for the techniques and related research support. We also provide references that offer more detailed discussion of the theory and application of the techniques. (PsycINFO Database Record (c) 2013 APA, all rights reserved).

Cognitive behavioral therapy for psychosis in clinical practice by Harry J. Sivec and Vicki L. Montesano, 2012, Psychotherapy, 49(2), 258-270.

Across continents, Cognitive-Behavioral Therapy for Psychosis (CBT-p) has been endorsed as an adjunctive treatment for individuals who experience persistent positive symptoms of schizophrenia. The moderate effect sizes reported in early studies and reviews were followed by better controlled studies indicating more limited effect sizes. This article provides a review of the literature that addresses the effectiveness of CBT-p, including particular areas of emphasis and practice elements associated with this approach. In addition, because the majority of research on CBT-p has been performed in the United Kingdom, implications for implementation and sustainability of this practice in the United States are presented.


BeST Center

BeST Practices in Schizophrenia Treatment (BeST) Center

Department of Psychiatry