In Review Functional Cognitive-Behavioural Therapy: A Brief, Individual Treatment for Functional Impairments Resulting From Psychotic Symptoms in Schizophrenia

his paper describes functional cognitive-behavioural therapy (FCBT) for persons with schizophrenia and other psychotic disorders. This approach was developed to extend the effects of cognitive-behavioural therapy (CBT) beyond symptom reduction. FCBT uses many elements of treatment found in other forms of CBT for psychosis but delivers them to different targets and with a different philosophy. Psychotic symptoms are addressed to the extent that they interfere with goal setting or achievement. Rather than discussing hallucina-tions or delusions as “real or unreal ” or “rational or distorted,” FCBT focuses on whether psychotic symptoms and responses to these symptoms interfere with attainment of specific social functioning goals. This motivational interviewing approach helps ensure that therapists always have a context for chal-lenging maladaptive responses to symptoms by evaluating whether these beliefs and actions help or hinder psychosocial goal attainment. Moreover, interventions tend not to focus on symptom reduction per se but, rather, on persisting toward goals in the face of symptoms. This paper provides a rationale for devising a therapy with a focus on functional impairment, describes FCBT, furnishes case examples illustrating the approach, and discusses preliminary research findings on FCBT