Treatments for Psychosis
While living with a psychotic disorder can pose many challenges, the Lieber Clinic believes that living a rich, full, and meaningful life is achievable. We offer cutting edge psychosocial treatments and supports that help people recover. Recovery can look different for different people, and at the Lieber Clinic, each individual sets their own treatment goals, and the team constructs a plan to support them. In this video Jules shares her inspiring story of recovery.
Psychosis includes a range of symptoms but typically involves one of these two major experiences: Hallucinations and Delusions
Hallucinations are seeing, hearing or feeling things that aren’t there, such as the following:
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Hearing voices (auditory hallucinations)
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Strange sensations or unexplainable feelings
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Seeing glimpses of objects or people that are not there or distortions
Delusions are strong beliefs that are not consistent with the person’s culture, are unlikely to be true and may seem irrational to others, such as the following:
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Believing external forces are controlling thoughts, feelings and behaviors
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Believing that trivial remarks, events or objects have personal meaning or significance
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Thinking you have special powers, are on a special mission or even that you are God.
We are still learning about how and why psychosis develops, but several factors, including genetics, trauma, substance abuse, physical illness and injury, and mental illness can all contribute.
Treatment
The Lieber Clinic offers group and individually-based treatments in which patients can learn skills to manage delusions and hallucinations, two common symptoms of psychosis. The objective of the treatment is to teach patients how to perform reality-testing, to decrease relative distress, and to reduce the degree to which psychotic thinking and phenomena interfere with everyday functioning. Treatments being offered include CBT for psychosis, DBT for psychosis, ACT for psychosis, and SCIT.
CBT for Psychosis
The therapeutic techniques used for patients with psychosis are based on the general principles of CBT. Links are established between thoughts, feelings, and actions in a collaborative and accepting atmosphere. We currently offer an 8-10 session CBT-based group, as well as limited individual CBTp therapy. This treatment focuses on understanding and modifying the factors that lead to emotional distress and behavioral disturbance. The goals of the group are: Increased understanding of and insight into psychotic experiences improved coping with residual psychotic symptoms, reduction in distress associated with auditory hallucinations, reduction of degree of conviction and preoccupation with delusional beliefs, and maintenance of gains and prevention of relapse. Individual CBT for psychosis is also available.
DBT for Psychosis
At the Lieber Clinic we have adapted Dialectical Behavioral Therapy, an evidence-based treatment for overwhelming emotions and interpersonal effectiveness, for individuals who experience symptoms of psychosis. In DBT groups individuals learn to practice mindfulness meditation, distress tolerance skills, emotion regulation skills and interpersonal effectiveness skills. Because psychotic symptoms are usually associated with distress, we use DBT strategies to manage those symptoms as well as to improve the ability to notice the onset of psychotic symptoms so that individuals can more rapidly utilize supports and increase self-care skills. Because cognitive deficits often accompany psychosis, this group thoroughly reviews each set of skills, explicitly connects skills with their practical application, and provides time for rehearsal to promote mastery and generalization.
Acceptance & Commitment Therapy for Psychosis
Acceptance and Commitment Therapy (ACT) is a relatively new form of therapy which helps you relate differently to your internal experiences (feelings, thoughts, cravings, hallucinations, memories, urges, compulsions), so that they don't dominate your attention, and dictate your behavior. The aim of ACT is to develop skills to respond more flexibly to these experiences and chose to act in ways that build the life you want. ACT is offered as a weekly group and an individual therapy devoted to helping people encounter difficult thoughts and emotions differently and pursue a full and meaningful life.
Social Cognition and Interaction Therapy
Social Cognition and Interaction Therapy (SCIT) is an evidence-based group treatment that targets the social cognitive deficits and biases that interfere with social functioning for individuals living with schizophrenia and other psychotic disorders — helping individuals better read social situations, manage emotional responses, and engage more confidently with others.
SCIT targets social cognitive deficits and biases using exercises, discussion of pictures and videos, games, and interpersonal strategies, and is offered as a weekly group.
First Episode Treatment
The Lieber Clinic supports young adults who are experiencing symptoms of psychosis for the first time. We provide evidence-based interventions to help young adults recover and stay on track in school, in finding employment and maintaining connections with family, friends and community. The earlier psychosis is identified and treated, the better the long-term outcomes. For more information on our first episode supports, please click HERE.
Treatment of Cognitive Deficits in Psychosis
Cognitive deficits are a core, persistent feature of psychotic disorders such as schizophrenia, bipolar disorder with psychotic features, and psychotic depression, and they significantly contribute to functional impairment. Areas of cognition which are especially vulnerable in psychosis, include:
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Memory
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Attention and concentration
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Executive function (planning, problem-solving, mental flexibility)
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Processing speed
Cognitive Remediation and Executive Functioning Skills groups are two, evidence-based approaches to addressing cognitive health concerns. For more information on these treatments, click HERE.