Psychotherapy for psychosis: integrating cognitive-behavioral and psychodynamic treatment

Lambrecht, Ingo

doi:10.1080/17522439.2019.1697732

Cited by 3 publications

(4 citation statements)

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“…MIT hypothesizes that it is possible to improve the effectiveness of psychotherapy for recovery in FEP by helping patients understand what psychotic symptoms mean in their personal experience, and in particular, how they arise as a response interpersonal event according to their pre-existing maladaptive schemas, for example being firmly convinced they are inferior, and that others will humiliate them. This perspective is consistent with cognitive-behavioural therapy (CBT) approaches to psychosis (Morrison, Renton, Dunn, Williams, & Bentall, 2003;Chadwick, 2008;Kingdon & Turkington, 2008;Garret, 2019), which focus on the personal experience of individuals with psychosis and the meaning they ascribe to their experiences. CBT emphasizes the role of negative self and other schemata in determining the personal meaning of relational events and the generation of fixed cognitions of threat.…”

supporting

confidence: 55%

Recovery-Focused Metacognitive Interpersonal Therapy (MIT) for Adolescents with First-Episode Psychosis

Inchausti

García‐Mieres

García-Poveda

et al. 2022

J Contemp Psychother

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Access to evidence-based early intervention for adolescents with psychosis is critically important.The aim of this work was analysing the feasibility, acceptability and potential effects of a psychological intervention based on metacognitive interpersonal therapy (MIT) in adolescents presenting with early psychosis. Twenty-three participants (aged 14-18) experiencing first-episode psychosis or an at-risk mental state for psychosis were offered up to 40 hours of individual MIT over a 12-month period. Effect sizes were calculated for changes in subjective recovery experience (primary outcome), psychotic symptoms (secondary outcome), and metacognition (hypothetical mechanism of change) from baseline to treatment end. At study completion, 21 out of 23 (91.3%) participants had received twelve or more sessions of MIT. The average number of MIT treatment sessions received was 31 (range 12-40). Large effect sizes were observed for changes in subjective recovery, self-reflectivity, understanding others' minds, mastery, and emotional distress. Medium effect sizes were observed for changes in negative, positive, and disorganized symptoms. This is the first study to suggest that MIT is both acceptable to young people experiencing early psychosis and is associated with improvements in subjective recovery, symptoms, and metacognition. Despite study limitations, evidence of MIT feasibility, acceptability and potential effects was sufficient to warrant further investigation.

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supporting

confidence: 55%

Recovery-Focused Metacognitive Interpersonal Therapy (MIT) for Adolescents with First-Episode Psychosis

Inchausti

García‐Mieres

García-Poveda

et al. 2022

J Contemp Psychother

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“…It strongly suggests a causal link, if not an outright identity, between a sense of connection and a sense of meaningfulness. There is a rich, if somewhat neglected, body of literature which views psychosis as a meaningmaking process (Arieti, 1955(Arieti, /1974Bentall, 2013;Martindale and Summers, 2013;Charles, 2017;Garrett, 2019, [see footnote p. 10 for an expanded reference list]; Ruffalo, 2019;Tan, 2022), and its treatment a process of examining these meanings (Larsen, 2004;Attard et al, 2017). Studies also suggest, consistent with Renee's treatment, that the key element in recovery from psychosis is establishing a trusting relationship with the therapist (Arieti, 1955(Arieti, /1974Winnicott, 1971;Stanghellini and Lysaker, 2007;Hartley, 2011;Koehler et al, 2013;Charles, 2017;Marcus, 2017;Garrett, 2019;Ruffalo, 2019;Tan, 2022).…”

Section: Linking the Sense Of Reality To Attachmentmentioning

confidence: 99%

“…There is a rich, if somewhat neglected, body of literature which views psychosis as a meaningmaking process (Arieti, 1955(Arieti, /1974Bentall, 2013;Martindale and Summers, 2013;Charles, 2017;Garrett, 2019, [see footnote p. 10 for an expanded reference list]; Ruffalo, 2019;Tan, 2022), and its treatment a process of examining these meanings (Larsen, 2004;Attard et al, 2017). Studies also suggest, consistent with Renee's treatment, that the key element in recovery from psychosis is establishing a trusting relationship with the therapist (Arieti, 1955(Arieti, /1974Winnicott, 1971;Stanghellini and Lysaker, 2007;Hartley, 2011;Koehler et al, 2013;Charles, 2017;Marcus, 2017;Garrett, 2019;Ruffalo, 2019;Tan, 2022). Trust arises from a long-term commitment on the part of the therapist to grasp the narrative meaning (make sense) of the psychotic person's hallucinatory and delusional (and other) experiences, very often by tracing them back to the phenomenal states discussed above: a loss of ipseity, a state of perplexity, diminished sense of agency, trust, meaningfulness, or pre-reflective common sense.…”

Section: Linking the Sense Of Reality To Attachmentmentioning

confidence: 99%

Meaningfulness and attachment: what dreams, psychosis and psychedelic states tell us about our need for connection

Fischman

2024

Front. Psychol.

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The human need to find meaning in life and the human need for connection may be two sides of the same coin, a coin forged in the developmental crucible of attachment. Our need for meaningfulness can be traced to our developmental need for connection in the attachment relationship. The free energy principle dictates that in order to resist a natural tendency towards disorder self-organizing systems must generate models that predict the hidden causes of phenomenal experience. In other words, they must make sense of things. In both an evolutionary and ontogenetic sense, the narrative self develops as a model that makes sense of experience. However, the self-model skews the interpretation of experience towards that which is predictable, or already “known.” One may say it causes us to “take things personally.” Meaning is felt more acutely when defenses are compromised, when the narrative self is offline. This enables meaning-making that is less egocentrically motivated. Dreams, psychosis, and psychedelic states offer glimpses of how we make sense of things absent a coherent narrative self. This has implications for the way we understand such states, and lays bare the powerful reach of attachment in shaping what we experience as meaningful.

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“…He was able to differentiate between his Fae world and consensual reality, but he was resistant to using a Cognitive Behavioral Therapy for Psychosis approach, which might question the status of his Fae world. The therapist decided to move forward with psychodynamic formulation in an effort to understand the figurative truth of the patient's delusions as it related to his first episode of psychosis (Garrett, 2019). Sessions soon evolved into his preference to present his experience to his new therapist (S. C.) as a personal narrative introducing his therapist to his fantastical identity and preferred reality.…”

Section: Case Reportmentioning

confidence: 99%

Capgras Syndrome: In the Conscious and the Unconscious Mind

et al. 2022

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We report the successful psychotherapy and medical treatment of a patient with an atypical presentation of Capgras syndrome, in which the patient not only believed that his parents were impostors but also believed that the entirety of what others would consider consensual reality was in fact an impostor. He insisted that a complex delusional world in which he wished to reside was authentic reality. His delusions of misidentification waxed and waned in response to discernable social stressors, and at times, he seemed to have conscious insight into the delusional nature of his beliefs. This case raises questions about whether Capgras should be considered a stand-alone diagnosis or whether it should be placed within a wider spectrum of psychotic disorders. Excepting our current report, although there are numerous reports of the resolution of Capgras after treatment with neuroleptics, we are unaware of descriptions in the literature of the successful treatment of medication-resistant Capgras with a combination of individual psychotherapy and pharmacological management.

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Psychotherapy for psychosis: integrating cognitive-behavioral and psychodynamic treatment

Cited by 3 publications

References 0 publications

Recovery-Focused Metacognitive Interpersonal Therapy (MIT) for Adolescents with First-Episode Psychosis

Recovery-Focused Metacognitive Interpersonal Therapy (MIT) for Adolescents with First-Episode Psychosis

Meaningfulness and attachment: what dreams, psychosis and psychedelic states tell us about our need for connection

Capgras Syndrome: In the Conscious and the Unconscious Mind

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