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CBT for schizophrenia

Published on 20-12-2018

Cognitive behavioural therapy plus standard care versus standard care plus other psychosocial treatments for people with schizophrenia

Cochrane Systematic Review, 15 November 2018

Implications for practice

  1. For people with schizophrenia

The use of cognitive behavioural therapy (CBT) has been associated with some reduction in symptoms of psychosis, particularly the positive symptoms of schizophrenia. However, there is considerable variability in the findings of the various studies and effect sizes tend to be quite modest. Therefore, at present, it is not possible to assert any substantial benefit for CBT in contrast to other psychological therapies.

  1. For clinicians

Currently, CBT for people with schizophrenia is a scarce commodity, often provided by highly‐skilled and experienced therapists. These data are not convincing of clear benefit over other ‐ and sometimes less sophisticated ‐ therapies for people with schizophrenia. There is some indication that CBT may help the positive symptoms of schizophrenia and there is mixed and inconsistent evidence for the benefit of CBT for psychosis on secondary anxiety and depression.

  1. For policy makers

Cognitive behavioural therapy may provide a useful add‐on to traditional treatment of people with schizophrenia. The nature of the randomised controlled trials of CBT included in this review and their small sample sizes demands caution until such time as data from larger, more methodologically coherent randomised controlled trials are available to supplement these findings.


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