Psychological Interventions in Early Psychosis : a Treatment Handbook
Every clinician knows that the human relationship with the person diagnosed with a psychotic disorder and particularly schizophrenia is the cornerstone of effective therapy and the foundation for recovery. This was one of the major tenets of an earlier generation of psychotherapeutic effort in schizophrenia and related psychoses but had drifted out of focus during the 1980s with the rise of an excessively narrow biological psychiatry and the decline of the traditional psychoanalytic approach.
The lack of a blueprint or body of knowledge and skills for working with psychotic patients meant that many of their most salient needs were ignored. Fortunately this situation is changing for the better.
Since the publication of Carlo Perris’ eclectic and seminal text in 1989, Cognitive Therapy with Schizophrenic Patients, there has been a steady growth in the application and evaluation of cognitive, cognitive-behavioural, and integrated need-adapted psychodynamic treatments for schizophrenia and psychosis. Over the past 5 years these developments have been reflected in the publication of a number of treatment handbooks for the clinician based in the mental health setting.
The majority of these treatment handbooks have presented the innovative cognitive-behavioural methods of UK-based clinical and experimental psychologists, and have reflected their contributions to the treatment of psychotic symptoms and relapse prevention. The principal aim of these texts has been to add to the repertoire of trained cognitive-behavioural therapists in their work with patients with established (and often treatment-resistant) forms of psychotic disorders.
Somewhat less attention has been paid to the earlier application of psychological interventions for first-episode patients whose clinical, personal and broader developmental needs often differ from patients with longer-term illnesses.
In parallel with this psychological renaissance, international interest in intensive early intervention in psychosis has grown exponentially. This paradigm shift is reflected in major research growth in early psychosis and a raft of service and policy reforms that have extended throughout Europe, Scandinavia, Canada, the USA, Australia and the Asia-Pacific region, in addition to the establishment of the International Early Psychosis Association, and the publication of several texts with a focus on early psychosis.
The International Society for the Psychological Treatments of the Schizophrenias and Other Psychoses similarly has expanded and given unequivocal support for the early use of psychological interventions in psychotic illness and for early intervention itself. Given these developments at the international and local service system level, we were motivated to bring together the range of psychological treatments for early psychosis. This text aims to equip clinicians to address the psychological needs of first-episode patients across specific early stages of treatment.
Psychological Interventions in Early Psychosis is envisaged as a practical treatment handbook for the clinician with previous training in a range of psychotherapies, and for the postgraduate student undertaking training. The text is organized according to phases of illness commencing with the prepsychotic at-risk phase and extending to protracted recovery from psychotic symptoms. In addition, the collection of contributions includes cognitive and cognitive-behavioural interventions which have not previously been described in available psychosis-related texts—namely suicide prevention and treatment of comorbid cannabis abuse.