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Abstract

第115巻第4号

Cognitive Behavioral Therapy for Psychosis to Promote Social Recovery
Syudo YAMASAKI
Department of Psychiatry & Behavioral Science, Tokyo Metropolitan Institute
Department of Neuropsychiatry, The University of Tokyo Hospital
Psychiatria et Neurologia Japonica 115: 379-384, 2013

 When conducting cognitive behavioral therapy for psychosis(CBTp), it is essential that therapists aim for the recovery of patients with psychosis. During the sessions, the therapist helps a person with psychosis understand their symptoms, manages his/her residual positive symptoms, and helps them to cope with distress from the positive symptoms by themselves.
 Such CBTp should be designed to achieve the goals of the patient’s social life. Recently, the effect of CBTp on residual positive symptoms of drug resistance has been reported repeatedly. Manifestation, cognitive bias, and activaters of residual positive symptoms differ considerably between individuals with psychosis.
 In the psychiatric rehabilitation field in Japan today, the symptom self‒management module is being used. The symptom self‒management module is derived from the techniques of group social skills training. However, there are needs for individual cognitive behavioral therapy for psychosis to meet the marked variation in individual needs.
 The effect of CBTp by itself on an individual with the initial episode of psychosis is limited. Many individuals with their first episode are teenagers or adolescents. Those patients are usually confronted with the problems of education and employment, which are key developmental tasks in adolescence. In order to meet those needs, a case manager should be assigned to an individual with first‒episode psychosis, and CBTp should be implemented within the case management process.
 The CBTp has been introduced in various forms for the purpose of recovery support of individuals with psychosis. For the future, not only the accumulation of evidence but also the development of a dissemination system of CBTp are required to meet the individual needs of patients.

Keywords:cognitive behavioral therapy, psychosis, recovery, community care>
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