Cognitive Behavioral Therapy for Psychotic Delusions and Hallucinations: A Case Report

Cognitive Behavioral Therapy for Psychotic Delusions and Hallucinations: A Case Report Diagnosis: The present case report describes a cognitive behavioral therapy for chronic delusions and hallucinations in a 29-year-old female outpatient suffering from paranoid schizophrenia. Therapy: Based on a specific therapist- patient-relationship a detailed case conceptualization could be developed. Cognitive biases (perception bias, jumping to conclusions bias) as well as safety behaviors (avoidance) contributed to the development and maintenance of symptoms. Motivation for the confrontation with frightening situations and reality testing could be enhanced through discussions about positive consequences of behavior modifications. The results of behavioral experiments were used to generate alternative explanations. Cognitive techniques for improving self-esteem and increased use of external resources helped stabilize the treatment outcome. Results: According to the assessment of an independent interviewer as well as the subjective experience of the patient, delusions were reduced considerably after the treatment. Hallucinations were not present any more. The stress caused by the symptoms was also reduced to a very low level. According to the patient's report her quality of life improved remarkably. Her social contacts broadened, she could sense enjoyment in her life again. Her ability to work improved, and as a consequence she was able to participate in a professional training for the general job market. Conclusion: The case described shows a successful cognitive behavioral treatment of chronic persistent delusions and hallucinations.