Cognitive behavioral therapy of negative symptoms

Negative symptoms account for much of the functional disability associated with schizophrenia and often persist despite pharmacological treatment. Cognitive behavioral therapy (CBT) is a promising adjunctive psychotherapy for negative symptoms. The treatment is based on a cognitive formulation in which negative symptoms arise and are maintained by dysfunctional beliefs that are a reaction to the neurocognitive impairment and discouraging life events frequently experienced by individuals with schizophrenia. This article outlines recent innovations in tailoring CBT for negative symptoms and functioning, including the use of a strong goal-oriented recovery approach, in-session exercises designed to disconfirm dysfunctional beliefs, and adaptations to circumvent neurocognitive and engagement difficulties. A case illustration is provided.

J Clin Psychol. 2009 Aug;65(8):815-30. Perivoliotis D, Cather C. University of Pennsylvania, 3535 Market St., Room 2032, Philadelphia, PA 19104, USA. dimitrip@mail.med.upenn.edu