Cognitive Behavioral Therapy (CBT) is a popular form of psychotherapy used to treat a vast array of psychological disorders. It focuses on challenging unhelpful beliefs and on analyzing their behavioral consequences. This therapy allows the patients to better identify their problems and teaches them to respond to such problems more efficiently.

The conventional structure of CBT was rethought and remodelled to target hallucinations, thereby yielding a new form of psychotherapy called Cognitive Behavioral Therapy for Psychosis (CBTp). As such, this personalized treatment better responds to the specific needs of individuals with treatment-resistant schizophrenia.

It is not the persecutory voices nor their contents that burden voice-hearers. Rather, it is the interpretation that these individuals make of their voices that generates psychological distress. CBTp modifies the patients’ appraisal of their voices by altering cognitive distorsions, reducing harmful behaviors, improving emotional regulation, and promoting new coping strategies. It also lowers distress by reducing the perceived power of the voices and by increasing control. Ultimately, this therapy improves the patients’ tolerance to their voices.

CBTp is currently the most efficient therapy option for treatment-resistant schizophrenia. It can reduce positive and negative symptoms, and improve daily functioning.


CBTp takes place in the form of nine weekly 60-minute therapy sessions. The sessions consist of various different learning modules and task assignments.

In CBTp, the patient-therapist relationship is of utmost importance. The work is accomplished in a structured manner that enables the patients to reach various therapeutic aims. More concretely, during this specialized therapy, the patients work with the therapist to reinforce their sense of control and to reduce the perceived power of their persecutory voices.


CBTp has several major therapeutic targets: normalizing the psychotic experience, providing a range of meaningful alternate explanations, developing a shared understanding of the voices, changing the appraisal of the voices, and testing unhelpful beliefs. This therapy also seeks to replace poor emotional regulation techniques with efficient coping strategies.

Through this practice, patients learn to cope with their persecutory voices. By becoming aware of the cognitive processes that guide their personal reactions, they develop an individualized formulation that enables them to make sense of their hallucinations.