CBT for those at risk of a first episode psychosis : evidence-based psychotherapy for people with an 'at risk mental state'

pt. I Theory and evidence -- 1. What is an At Risk Mental State? -- What is the incidence of psychosis in ARMS? -- Prevalence and incidence of psychotic-like experiences -- Closing-in strategy -- What is the risk of psychosis in help-seeking ARMS subjects? -- Ethical issues -- 2. How to identify ARMS subjects? -- Importance of identifying ARMS subjects -- Instruments -- Procedure -- Conclusion -- CAARMS case examples -- Ibrahim -- Ben -- Agnes -- 3. What are extraordinary experiences? -- Several kinds of extraordinary experiences -- Sensory experiences -- Distorted self-experiences -- Ideas of reference -- Speech and motor derailment -- 4. Which cognitive biases are associated with ARMS? -- Perceptual bias -- Selective attention for threat (seeing danger anywhere) -- Memory biases -- Source monitoring and hallucinations (remembering thoughts and phrases as originating from others) -- Hindsight bias (I knew it all along) -- Attribution bias -- Self serving bias and personalisation bias (blaming others for failure) -- Covariation bias (overestimation of causality and underestimation of chance) -- Reasoning biases -- Jumping to conclusions/data-gathering bias (hasty conclusions) -- Negative expectation bias (pessimism) -- Dogmatism/belief inflexibility bias (I know I am right, I need no proof) -- Emotional reasoning (because if I feel anxious, there must be danger) -- Confirmation bias (bias against disconfirmatory evidence) -- Behavioural bias -- Avoidance behaviour (evading threat) -- 5. nature of cognitive biases -- Are some cognitive biases endophenotypes? -- Transdiagnostic biases -- Dopamine sensitisation, cognitive biases and extraordinary experiences -- Are cognitive biases open to change? -- Cognitive bias modification in anxiety and mood disorders -- Cognitive biases, anxiety; depression and subclinical psychotic symptoms -- Effects of metacognitive training in psychosis -- 6. Evidence for preventing or postponing a first episode psychosis -- Introduction -- Goals of early detection -- Evidence for early intervention -- Dutch Early Detection and Intervention Evaluation trial (EDIE-NL) -- Participants -- Interventions -- Results -- Evidence for the protocol -- pt. II Practice of CBT for ultra-high risk -- 7. manual for coping with extraordinary and remarkable experiences -- Rationale of the treatment -- Manual: `coping With Extraordinary And Remarkable Experiences' -- (1). Introduction and (2) Pre-assessment (one session) -- (3). Psycho-education and normalising (one session) -- (4). CBT assessment and metacognitive training (six sessions) -- (5). Case formulation and goal setting (one session) -- (6). Cognitive behavioural intervention (6 to 12 sessions) -- (7). Post-assessment (one session) -- (8). Consolidation (one session) -- (9). Booster sessions (for instance, four sessions) -- 8. Typical vignettes of treatment cases -- When suspicion starts to impede functioning -- Introduction and assessment -- Normalising information and alternative explanations -- Metacognitive training -- Case formulation -- Cognitive behavioural therapy -- Relapse prevention and end of therapy -- When coincidence does not exist -- Introduction and assessment -- Normalising information and alternative explanations -- Metacognitive training -- Case formulation -- Cognitive behavioural therapy -- Relapse prevention and end of therapy -- When experiences and thoughts become intrusive -- Introduction and assessment -- Normalising information and alternative explanations -- Metacognitive training -- Case formulation -- Cognitive behavioural therapy -- Relapse prevention and end of therapy -- When ghosts are haunting -- Introduction and assessment -- Normalising information and alternative explanations -- Metacognitive training -- Case formulation -- Cognitive behavioural therapy -- Relapse prevention and end of therapy -- Losing touch with reality -- Introduction and assessment -- Normalising information and alternative explanations -- Metacognitive training -- Case formulation -- Cognitive behavioural therapy -- Relapse prevention and end of therapy -- Magical thinking -- Introduction and assessment -- Normalising information and alternative explanations -- Metacognitive training -- Case formulation -- Cognitive behavioural therapy -- Relapse prevention and end of therapy.

Mental illness is highly prevalent in the general population and has its onset mostly in adolescence and young adulthood. Early intervention usually leads to improved prognosis. This book describes an evidence-based cognitive behavioural intervention that can be used by clinicians to treat the precursor symptoms of psychosis and other severe mental illness to help reduce the chance of transition to a first psychotic episode and to improve the chance for recovery. The book offers psycho-education about prepsychotic symptoms; a review of literature about psychological processes that are known to play a role in the development of psychosis; a comprehensive manual that can be used to treat help-seeking subjects with an increased risk of developing psychosis; links to online resources and exercises to be used in therapy and education; and a description of the randomized clinical trial investigating this new psychotherapy.

BL