Beyond training: CBT tips for therapists

CrossCurrents

 

Adopting a new treatment modality is always a challenge for mental health professionals. Here, practitioners who are already using CBT for schizophrenia offer tips for success.

Dr. Gail Myhr, director of the McGill University Health Centre CBT Unit in Montreal, acknowledges that while CBT therapists may be comfortable helping clients with anxiety and depression, they may not be as comfortable talking about the kinds of unusual and sometimes alarming thoughts that people with psychosis may have. “When people are telling you things that are surprising to you, or that don’t fit what you know of the world, it can be upsetting at the beginning,” Myhr says. But all those thoughts can be discussed in CBT. “Just remember the underlying message that people with psychosis or schizophrenia are not fundamentally different from anyone else. Then you have the confidence to move ahead and try new forms of treatment.”

For Virginia Lafond of the Royal Ottawa Hospital’s schizophrenia program, acknowledging the grieving of mental illness in CBT work is key: “The person is often restive, discontent, rarely happy with him- or herself,” she says. “Conscious, constructive use of the grieving process can help bring resolution of the practical problems.” Lafond encourages clients to use two key coping questions: How can I help myself cope with a specific problem? Can I put the feeling of anger or fear or sadness etc. to constructive use?

Helene Racine, director of nursing and director of quality at the Douglas University Mental Health Institute in Montreal, says it is important to be confident that clients can learn these skills. “Stay open-minded,” she says. “If you are open-minded that they can achieve things on their own, then they can be successful at achieving what they want and they can learn about their own thought processes.”

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