Treating psychosis : a clinician's guide to integrating acceptance & commitment therapy, compassion-focused therapy & mindfulness approaches within the cognitive behavioral therapy tradition

289 Pages·2014·2.25 MB·English

by  Andrew M.

“In Treating Psychosis, Wright and her coauthors provide the reader with a treasure trove of
cutting-edge cognitive behavioral therapy (CBT) techniques for treating psychosis—all in one
succinct volume. Reflecting the evolution of CBT for psychosis over recent years, the authors
outline a comprehensive treatment plan that will aid clinicians in making the best use of the
myriad psychological strategies that have proven immensely helpful for individuals living with
psychosis. The integrative model described in the book expertly links core CBT principles with
the latest in mindfulness, acceptance, and compassion-focused strategies, producing an innova-
tive new approach.”
—Brandon A. Gaudiano, PhD, assistant professor at the
Warren Alpert Medical School of Brown University and
research psychologist at Butler Hospital in Providence, RI
“Building on both established cognitive behavioral research, practice, and treatment for psy-
chosis and emerging work on acceptance-based and related approaches, the authors have put
together a clear and highly practical therapist guide for the integrated treatment of psychosis.
In addition to a comprehensive discussion of treatment processes and techniques, Treating
Psychosis includes more than seventy pages of reproducible forms and handouts. This book is
strongly recommended to anyone who treats psychotic disorders, either in groups or
individually.”
—Martin M. Antony, PhD, ABPP, professor of psychology
at Ryerson University and author of The Shyness and Social
Anxiety Workbook
Treating Psychosis
B
Tr e at ing
P s y c ho si s
A Clinician’s Guide to Integrating
Acceptance & Commitment Therapy,
Compassion-Focused Therapy &
Mindfulness Approaches within the
Cognitive Behavioral Therapy Tradition
Nicola P. Wright, PhD, CPsych
Douglas Turkington, MD
Owen P. Kelly, PhD, CPsych
David Davies, PhD, CPsych
Andrew M. Jacobs, PsyD, CPsych
Jennifer Hopton, MA
New Harbinger Publications, Inc.
Publisher’s Note
This publication is designed to provide accurate and authoritative information in regard to the subject matter covered. It is sold with the understanding that the publisher
is not engaged in rendering psychological, financial, legal, or other professional services. If expert assistance or counseling is needed, the services of a competent profes-
sional should be sought.
“Emotion Regulation Systems” diagram from THE COMPASSIONATE MIND by Paul Gilbert, copyright © 2009 Paul Gilbert. Reprinted by permission of
Constable & Robinson, Ltd.
“Form 4.1: Areas to Cover in Assessment” adapted from “Appendix C” in SCHIZOPHRENIA: THEORY, RESEARCH, AND THERAPY by Aaron T.
Beck, Neil A. Rector, Neal Stolar, and Paul Grant, copyright © 2009 by The Guilford Press. Adapted by permission of The Guilford Press.
“Form 6.3: Strategies for Coping with Emotions,” “Form 8.3: Behavioral Experiments for Distressing Thoughts or Delusions,” “Form 9.5: Evidence for and
Against Beliefs About the Content of Voices,” “Form 9.6: Evidence for and Against Beliefs About the Cause or Origin of Voices,” and “Form 9.9: Behavioral
Experiment for Beliefs About Voices” modified from “Evaluating Beliefs About Voices” (p. 134), “Behavioural Experiments Form” (p. 139), and “Evaluating
Coping Strategies” (p. 140) in THINK YOU’RE CRAZY? THINK AGAIN by Anthony P. Morrison, Julia Renton, Paul French, and Richard Bentall, copy-
right © 2008 Routledge / Taylor & Francis Group. Adapted with permission.
“Form 7.2: Activity Form” modified from “Activity Record” in C. W. Lejuez, D. R. Hopko, and S. D. Hopko. (2001). “A Brief Behavioral Activation
Treatment for Depression: Treatment Manual.” Behavior Modification 25(2):255–286. Copyright © 2001 Sage Publications, Inc. Adapted with permission.
“Form 8.2: Pie Chart for Alternative Explanations” and “Form 9.8: Pie Chart for Explanation of Voices” adapted from COGNITIVE THERAPY
TECHNIQUES: A PRACTITIONER’S GUIDE by Robert L. Leahy, copyright © 2003 by The Guilford Press. Adapted by permission of The Guilford Press.
Distributed in Canada by Raincoast Books
Copyright © 2014 by N icola P. Wright, Douglas Turkington, Owen P. Kelly, David R. T. Davies, Andrew M. Jacobs,
and Jennifer Hopton
New Harbinger Publications, Inc.
5674 Shattuck Avenue
Oakland, CA 94609
www.newharbinger.com
Cover design by Amy Shoup
Acquired by Tesilya Hanauer
Edited by Jean Blomquist
Indexed by James Minkin
All Rights Reserved
Library of Congress Cataloging-in-Publication Data
Wright, Nicola P., author.
Treating psychosis : a clinician’s guide to integrating acceptance and commitment therapy, compassion-focused therapy, and mindfulness approaches
within the cognitive behavioral therapy tradition / Nicola P. Wright, Owen Kelly, Douglas Turkington, David Davies, Andrew M. Jacobs, and Jennifer
Hopton.
p. ; cm.
Includes bibliographical references and index.
Summary: “Treating Psychosis is an evidence-based treatment manual for mental health professionals working with individuals who experience psychosis,
a serious form of mental illness that causes delusions, hallucinations, and thought disorders. Psychosis is usually associated with schizophrenia, bipolar
disorder, post-traumatic stress disorder, and severe depression. This is the first professional book to use a compassionate, mindful approach to treating
psychosis using acceptance and commitment therapy (ACT) and compassion-focused therapy (CFT). The book provides clinicians with a pre-treatment
overview and treatment implementation strategies, and focuses on developing a realistic action plan for treating patients with psychosis, as well as
maintaining wellness”--Provided by publisher.
ISBN 978-1-60882-407-6 (paperback : alk. paper) -- ISBN 978-1-60882-408-3 (PDF e-book) -- ISBN 978-1-60882-409-0 (ePub)
I. Title.
[DNLM: 1. Psychotic Disorders--therapy. 2. Acceptance and Commitment Therapy--methods. 3. Mindfulness. 4. Patient Care Planning. WM 200]
RC489.C63
616.89’1425--dc23
2014009368
To Dr. Aaron Beck, whose vision and approaches have changed countless lives.
Through his passion for understanding and working with those with psychosis, Dr. Beck has
depathologized psychosis and made it possible for so many to pursue their goals and dreams as well
as live fuller and more meaningful lives.
—The Authors
*
To my clients and those with lived experience of psychosis, who inspire me and have made my work
and life so meaningful.
To my daughter, Emma, whose presence reminds me every day of the beauty and power of love.
To Dave, with love, for sharing part of the journey.
—NW
To my wife and family, who support me in all my travels, workshops, and writings.
—DT
To Natalie, Eliza, and Mariska, my family, my friends, and all my clients from whom I have learned
so very much.
—OK
To Emma and Nic.
—DD
To the past, present, and future members of Yahara House.
—AJ
To R. A. H., in recognition of your struggles, successes, strength, and humanity. May you know
peace. And to Guy, my love.
—JH

Contents
List of Figures vi
List of Forms vii
Foreword ix
Acknowledgments xi
A Note About Integration and Application of Therapeutic Approaches
and Language xv
Part 1: Pretreatment Overview
1 Introduction to Integrative Treatment for Psychosis 3
2 Conceptual Model 8
3 Group Implementation 18
Part 2: Treatment Modules
4 Module 1: The Therapeutic Relationship, Engagement, and Assessment 25
5 M odule 2: Conceptualization and Treatment Planning: Strengths, Values,
and Goals 42
6 Module 3: Emotion Regulation and Resilience 56
7 M odule 4: Action Toward Valued Goals: Overcoming Barriers to
Value-Consistent Living 81
8 M odule 5: Understanding, Assessing, and Treating Distressing Thoughts
and Delusions 97
9 Module 6: Understanding and Working with Voices 119
10 Module 7: Accomplishments and Staying Well Plan—Ongoing Recovery,
Valued Life Goals, and Staying Well 144
Part 3: Further Considerations
11 Special Considerations and Comorbidity 153
12 Some Final Thoughts 159
Appendix: Forms 161
Resources 229
Reference List 247
Index 266
List of Figures
Figure 2.1 Emotion Regulation Systems (Gilbert, 2009) 12
Figure 2.2 Integrated Treatment Model 16
Figure 5.1 Sample Cognitive Behavioral Conceptualization 47
Figure 5.2 Cognitive Behavioral Conceptualization 48
Figure 8.1 Timeline for Working with Distressing Thoughts/Delusions 115
Figure 9.1 Sample Cognitive Behavioral Conceptualization for Voices 127
Figure 9.2 ABC Model of Voices 133
Form 9.3 ABC for Voices Form: Example 134
List of Forms
The following forms are available for download at http://www.newharbinger.com/24076. Please see the
back of this book for instructions on how to access them.
Form 4.1: Areas to Cover in Assessment 162
Form 4.2: Coping Exercises 169
Form 4.3: Strengths, Coping Strategies, and Resources List 172
Form 5.1: Session Summary 174
Form 5.2: Cognitive Behavioral Conceptualization 176
Form 5.3: Core Beliefs 177
Form 5.4: Values Worksheet 178
Form 5.5: Goal Setting 181
Form 5.6: Treatment Plan 183
Form 6.1: Understanding Emotions 184
Form 6.2: Emotion List 185
Form 6.3: Strategies for Coping with Emotions 186
Form 6.4: V alued Activities, Willingness, Values, and Goals 187
Form 6.5: Compassion-Focused Exercises 189
Form 6.6: Thinking Styles 192
Form 6.7: T he 3Cs and 4Cs—Catch It, Check It, Change It (with Compassion) 196
Form 6.8: Positive Emotion Exercises 197
Form 7.1: ABC for Action 198
Form 7.2: Activity Form 199
Form 7.3: Values and Valued Activities 200