Schizophrenia: Cognitive Theory, Research, and Therapy

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From Aaron T. Beck and colleagues, this is the definitive work on the cognitive model of schizophrenia and its treatment. The volume integrates cognitive-behavioral and biological knowledge into a state-of-the-science conceptual framework. It comprehensively examines the origins, development, and maintenance of key symptom areas: delusions, hallucinations, negative symptoms, and formal thought disorder. Treatment chapters then offer concrete guidance for addressing each type of symptom, complete with case ...
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Overview

From Aaron T. Beck and colleagues, this is the definitive work on the cognitive model of schizophrenia and its treatment. The volume integrates cognitive-behavioral and biological knowledge into a state-of-the-science conceptual framework. It comprehensively examines the origins, development, and maintenance of key symptom areas: delusions, hallucinations, negative symptoms, and formal thought disorder. Treatment chapters then offer concrete guidance for addressing each type of symptom, complete with case examples and session outlines. Anyone who treats or studies serious mental illness will find a new level of understanding and the latest theoretically and empirically grounded clinical techniques.
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Editorial Reviews

From The Critics
Reviewer: Gary B Kaniuk, Psy.D.(Cermak Health Services)
Description: This book describes schizophrenia from a cognitive theoretical and biological perspective in order to understand symptomatology, assessment, and treatment. t shows how pharmacotherapy and psychosocial interventions can work hand-in-hand within a solid evidence-based foundation.
Purpose: According to the authors, "We have attempted to provide, first, an understanding of the origin, development, and maintenance of the symptoms (delusions, hallucinations, thinking disorder, and negative symptoms). Second, we have used our understanding of the symptomatology and our therapeutic experience fortified by the research in this area to present our suggestions for the treatment of this disorder. Finally, we have attempted to integrate the vast amount of research on the biology of schizophrenia with the relatively sparse work on its psychological aspects into a comprehensive psychobiological model of schizophrenia."
Audience: The audience includes clinical psychologists, social workers, psychiatrists, psychiatric nurses, and rehabilitation specialists, as well as graduate students and residents in these fields. Dr. Aaron Beck, professor emeritus of psychiatry at the University of Pennsylvania and president of the Beck Institute, developed cognitive therapy in the 1960s. Dr. Neil Rector is director of research at the Sunnybrook Health Sciences Centre in Toronto and is a founding fellow of the Academy of Cognitive Therapy, as is Dr. Neal Stolar, medical director at Project Transition in the Philadelphia area. Dr. Paul Grant is director of research in the department of psychiatry at the University of Pennsylvania.
Features: An overview and biological look at schizophrenia begins the book, which then addresses the actual symptomatology from a cognitive perspective. The authors discuss both assessment and therapy issues, concluding by summarizing their integrative model of the interaction of "predisposing neurobiological, environmental, cognitive, and behavioral factors in the development of schizophrenia." The book does a nice job of addressing the importance of the therapeutic relationship, combining both process and content issues, an approach not often seen in cognitive therapy books. It contains excellent tables and figures, along with instructive case illustrations/vignettes. The eight appendixes contain assessment tools (Beck Cognitive Insight Scale, Cognitive Assessment of Psychosis Inventory), cognitive triads for delusional beliefs, and cognitive distortions within psychosis. The book combines theory, research, and practice very well. The story of John Nash's recovery from schizophrenia in the first chapter gives readers a good sense of where the book is headed and how the cognitive approach makes sense as opposed to a strictly biological model.
Assessment: This excellent book provides a thorough look at schizophrenia from both a biological and psychosocial perspective. Its step-by-step approach combines both research and practice. The authors address all the difficult issues including hallucinations, delusions, and negative symptoms, and show how the cognitive model can be applied. The book gives clinicians hope that something can be done to help individuals suffering from such a devastating mental illness.
American Journal of Psychiatry
"Therapists and psychiatrists will discover many approaches that will be useful in working with patients with psychosis in a variety of settings and situations beyond the formal cognitive therapy session....This rich and powerful book will be valuable to anyone in the field of mental health who works with people with psychotic disorders and who would like to be able to do more to help them."--American Journal of Psychiatry

— Richard Warner

Psychological Medicine

"In its 14 chapters, the reader is treated to not only a detailed presentation of cognitive therapy and practice in schizophrenia, but also a rich overview of the disorder and current biological models that conceive of cognitive deficits as the central core of schizophrenic psychopathology....The authors make a persuasive case that, when used in conjunction with pharmacotherapy, cognitive therapy could become a key ingredient in offering hope and recovery to many patients with schizophrenia."--Psychological Medicine

— Anand K. Pandurangi

Journal of Psychosomatic Research

"The major achievement of [this book]...can...be seen in the integration of cognitive-behavioral and biological knowledge into a conceptual framework. This is achieved by comprehensively examining various domains of research on the origins, development, and maintenance of key symptoms....Four detailed chapters provide cognitive conceptualizations of delusions, hallucinations, negative symptoms, and formal thought disorder. These conceptualizations reflect the careful thinking of talented clinicians who have immersed themselves in their subject and achieved valuable insights....The chapters on treatment....Offer concrete and detailed guidance for addressing each type of symptom, complete with case examples. They reflect the authors'' considerable experience disseminating this therapeutic approach and I expect even experienced clinicians to find them extremely helpful....It is fascinating to be reminded in this book of how much research in schizophrenia has expanded over the last decades. By bringing together a lot of this research and generating new ideas, this book is sure to add to further major developments in our ideas about schizophrenia."--Journal of Psychosomatic Research

— Tania M. Lincoln

American Journal of Psychiatry
"Therapists and psychiatrists will discover many approaches that will be useful in working with patients with psychosis in a variety of settings and situations beyond the formal cognitive therapy session....This rich and powerful book will be valuable to anyone in the field of mental health who works with people with psychotic disorders and who would like to be able to do more to help them."--American Journal of Psychiatry
Psychological Medicine
"In its 14 chapters, the reader is treated to not only a detailed presentation of cognitive therapy and practice in schizophrenia, but also a rich overview of the disorder and current biological models that conceive of cognitive deficits as the central core of schizophrenic psychopathology....The authors make a persuasive case that, when used in conjunction with pharmacotherapy, cognitive therapy could become a key ingredient in offering hope and recovery to many patients with schizophrenia."--Psychological Medicine
Journal of Psychosomatic Research
"The major achievement of [this book]...can...be seen in the integration of cognitive-behavioral and biological knowledge into a conceptual framework. This is achieved by comprehensively examining various domains of research on the origins, development, and maintenance of key symptoms....Four detailed chapters provide cognitive conceptualizations of delusions, hallucinations, negative symptoms, and formal thought disorder. These conceptualizations reflect the careful thinking of talented clinicians who have immersed themselves in their subject and achieved valuable insights....The chapters on treatment....Offer concrete and detailed guidance for addressing each type of symptom, complete with case examples. They reflect the authors' considerable experience disseminating this therapeutic approach and I expect even experienced clinicians to find them extremely helpful....It is fascinating to be reminded in this book of how much research in schizophrenia has expanded over the last decades. By bringing together a lot of this research and generating new ideas, this book is sure to add to further major developments in our ideas about schizophrenia."--Journal of Psychosomatic Research
Social Service Review
"This book, like others written by Beck, provides a thoughtful integration of research, theory, and wisdom gained from many years of practice. It provides the reader with a solid conceptual understanding of the phenomenology and factors associated with the development and course of schizophrenia....Beck and associates have produced a very thoughtful and timely work that brings together research, theory, and practice elements from a number of areas....One of the primary strengths is the extent to which the authors have integrated cognitive and biological science in their formulations of the symptom clusters and in their integrative theory of schizophrenia. The theoretical chapters provide the reader with an excellent review and critique of the research on cognitive functioning, neurobiology, and psychophysiology of schizophrenia."--Social Service Review
MIWatch.org
"This book is a thoughtful, well-documented attempt to provide both a theoretical rationale and a set of useful tools for the therapeutic encounter with a still mysterious and troubling illness."--MIWatch.org
Psychiatric Rehabilitation Journal
"Interesting, clearly written, and filled with thought-provoking and useful information, this text is an excellent resource for clinicians wanting to understand cognitive theory and techniques and their use in the treatment of individuals with psychosis. Concepts are presented to provide accessibility to clinicians specializing in psychosis but less familiar with cognitive techniques as well as clinicians well-versed in the use of cognitive techniques but with less experience treating people with psychotic symptoms. Aaron Beck, a pioneer in defining cognitive treatment of depression and anxiety, is in a unique position to elucidate differences and similarities between using cognitive treatment in psychosis and in more traditional diagnoses....A valuable resource that practitioners will find themselves using frequently in their work."--Psychiatric Rehabilitation Journal
Psychiatric Services
"For graduate students, residents, current practitioners, and others seeking a single body of work to deepen their understanding of schizophrenia and treatment approaches benefiting those affected by the syndrome, [this book] is made to order....The authors are recognized leaders in promoting the cognitive model of schizophrenia and its treatment. Yet, this book goes well beyond the model by providing a concise, historic overview of how schizophrenia has been conceptualized and addressed and how contemporary biological knowledge can be integrated with the cognitive model to address this serious disorder....In developing this book, the authors clearly set a high bar with an ambitious set of objectives: providing a historical overview of schizophrenia; describing the syndrome's etiology; synthesizing theory, research, and practice; offering cognitive and biological perspectives; and providing practical advice to treatment providers. In each instance, the book has met the challenge. It is recommended for professionals across health disciplines as well as others interested in state-of-the-art treatment approaches to schizophrenia."--Psychiatric Services
Cognitive Behavioral Therapy Book Reviews
"A comprehensive volume that is a guide to learning and applying cognitive therapy to schizophrenia. This fills a critical gap....It is exceptional in that it is filled with clinical insights and suggestions based on experience....The book is also exceptional in its clarity and depth of coverage....This book will stand as a classic leading to a generation of therapists able to bring hope and clinically important help to those suffering from schizophrenia. Beck and colleagues have completed the circle from a tantalizing case study over 50 years ago to a well formulated guide to understanding psychotic symptoms and applying cognitive therapy."--Cognitive Behavioral Therapy Book Reviews
Schizophrenia Magazine
"The book offers detailed guidance for formulating individual cases and tailoring cognitive and behavioral interventions to meet each patient's needs....Combining cognitive therapy and pharmacotherapy, the book provides valuable advice on engaging patients who may be fearful or suspicious. It is a comprehensive and convincing reference for practitioners, including clinical psychologists, social workers, psychiatrists, psychiatric nurses, rehabilitation specialists, and graduate students."--Schizophrenia Magazine
Journal of Behavioural and Cognitive Psychotherapy
"This book manages something that none has yet achieved: it provides an authoritative, measured, clear, and up-to-date overview of a huge breadth of material, whilst giving sufficient depth to leave the reader satisfied that they know enough to inform on good clinical practice....The clear writing style helps the reader get to grips with some of the complexities of the neuroanatomy and neurochemistry of the disorder, something that I have often found rather less transparent in other sources....I recommend this book wholeheartedly to all clinicians with an interest in the cognitive theory and/or therapy of schizophrenia. It is an invaluable summary of the current state of the art."--Journal of Behavioural and Cognitive Psychotherapy
From the Publisher
"Synthesizing research on the psychology and biology of schizophrenia, Beck et al. show how a cognitive approach can be used to understand and treat even the most severely ill patient. This book is a masterpiece that challenges conventional thinking and describes one of the most exciting developments in psychiatry today. It is essential reading for all mental health professionals."--Richard Bentall, PhD, Professor of Clinical Psychology, University of Bangor, UK "This volume offers a window into the world of an individual with schizophrenia by revealing how disturbed neurobiology can cause normal thought processes to evolve into psychosis. The authors describe how both clinicians and patients can better understand schizophrenia symptoms using CBT--and how the process of doing so can be powerfully therapeutic."--Stephen R. Marder, MD, Professor and Director, Section on Psychosis, Semel Institute, UCLA "Beck and his colleagues have done it again! This book is simply outstanding. It begins with a very clear and insightful overview of our scientific understanding of the etiology of schizophrenia, offers detailed analyses of the cognitive underpinnings of psychotic symptoms, and then outlines specific approaches for tailoring cognitive techniques to treat these symptoms. Unlike many authors who address schizophrenia treatment, Beck et al. clearly link science with treatment strategies. I plan to use this book as the primary text in my seminars on clinical treatment."--Elaine F. Walker, PhD, Samuel Candler Dobbs Professor of Psychology and Neuroscience, Emory University "The time has assuredly come for all clinicians working with persons with schizophrenia to become well acquainted with cognitive therapy for psychosis. Beck's decades of experience and wisdom are clearly reflected in this book. The cognitive conceptualizations of delusions, hallucinations, negative symptoms, and formal thought disorder are especially compelling and will provide critical new insights for both trainees and seasoned clinicians. This is an important addition to the library of any clinician committed to supporting recovery in persons with schizophrenia."--Shirley M. Glynn, PhD, Research Psychologist, Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, UCLA

"Beck et al. have written the rare book that succeeds in wedding theory, research, and practice into a cohesive conceptual framework. The book provides an integrated theoretical model that accounts for the disparate symptoms of schizophrenia. These theoretical foundations are complemented by excellent, detailed clinical guidelines, vignettes, sample dialogues, and useful tools. An outstanding resource for researchers and clinicians who want to better understand the role of cognitive factors in schizophrenia and its treatment."--Kim T. Mueser, PhD, Executive Director, Center for Psychiatric Rehabilitation, Boston University

"Many of the puzzling and vexing symptoms of schizophrenia are largely untouched by existing psychosocial and psychopharmacological treatments. Beck and his colleagues present an integrated, empirically based theory of the disorder which provides the foundation for identifying effective therapeutic strategies. Logically presented, scholarly, and generously illustrated with case examples, this book will serve as a practical guide for practitioners seeking to improve their effectiveness, as well as program leaders seeking to augment the continuum of care for this population. I strongly recommend this text for graduate and professional training programs in psychiatry, clinical psychology, social work, psychiatric nursing, and psychiatric rehabilitation."--Gary R. Bond, PhD, Chancellor's Professor of Psychology, Indiana University-Purdue University Indianapolis

"This is the most comprehensive and yet lucidly written book on cognitive theory and therapy of schizophrenia I have ever read. That's no surprise, given that Beck pioneered the development of cognitive-behavioral therapy for schizophrenia. What is remarkable here is the optimal balance between breadth (from biology and pharmacology to psychology and social services) and depth (detailed understanding of cognitive deficits and their treatment). The book is 'must' reading for anyone interested in schizophrenia, from the pre- or postdoctoral student to the teacher, clinician, or researcher. Everyday case examples and direct quotes from actual therapy sessions, combined with relevant rating scales, research findings, and a detailed bibliography, make this volume a one-stop source for all the necessary information in this area."--Dilip V. Jeste, MD, Distinguished Professor of Psychiatry and Neurosciences, University of California, San Diego

"This book represents a major advance in the application of cognitive theory and therapy. It is fitting that the founder of cognitive therapy is now pioneering its use with people with schizophrenia, who were once thought to be virtually untreatable. The authors provide a groundbreaking integration of neurobiological and cognitive-behavioral approaches to understanding the disorder and improving patients' lives. Unique contributions of the book include the descriptions of cognitive distortions and cognitive triads specific to schizophrenia and the development of cognitive models of thought disorder and negative symptoms, which have been neglected until now."--Tony Morrison, ClinPsyD, Professor of Clinical Psychology and Associate Director of Early Intervention, University of Manchester, UK

Social Service Review - Stanley G. McCracken
"This book, like others written by Beck, provides a thoughtful integration of research, theory, and wisdom gained from many years of practice. It provides the reader with a solid conceptual understanding of the phenomenology and factors associated with the development and course of schizophrenia....Beck and associates have produced a very thoughtful and timely work that brings together research, theory, and practice elements from a number of areas....One of the primary strengths is the extent to which the authors have integrated cognitive and biological science in their formulations of the symptom clusters and in their integrative theory of schizophrenia. The theoretical chapters provide the reader with an excellent review and critique of the research on cognitive functioning, neurobiology, and psychophysiology of schizophrenia."--Social Service Review
MIWatch.org - Richard Evans
"This book is a thoughtful, well-documented attempt to provide both a theoretical rationale and a set of useful tools for the therapeutic encounter with a still mysterious and troubling illness."--MIWatch.org
Psychiatric Rehabilitation Journal - Sandra Wilkniss and Kristin Davis
"Interesting, clearly written, and filled with thought-provoking and useful information, this text is an excellent resource for clinicians wanting to understand cognitive theory and techniques and their use in the treatment of individuals with psychosis. Concepts are presented to provide accessibility to clinicians specializing in psychosis but less familiar with cognitive techniques as well as clinicians well-versed in the use of cognitive techniques but with less experience treating people with psychotic symptoms. Aaron Beck, a pioneer in defining cognitive treatment of depression and anxiety, is in a unique position to elucidate differences and similarities between using cognitive treatment in psychosis and in more traditional diagnoses....A valuable resource that practitioners will find themselves using frequently in their work."--Psychiatric Rehabilitation Journal
Journal of Psychosomatic Research - Tania M. Lincoln
"The major achievement of [this book]...can...be seen in the integration of cognitive-behavioral and biological knowledge into a conceptual framework. This is achieved by comprehensively examining various domains of research on the origins, development, and maintenance of key symptoms....Four detailed chapters provide cognitive conceptualizations of delusions, hallucinations, negative symptoms, and formal thought disorder. These conceptualizations reflect the careful thinking of talented clinicians who have immersed themselves in their subject and achieved valuable insights....The chapters on treatment....Offer concrete and detailed guidance for addressing each type of symptom, complete with case examples. They reflect the authors' considerable experience disseminating this therapeutic approach and I expect even experienced clinicians to find them extremely helpful....It is fascinating to be reminded in this book of how much research in schizophrenia has expanded over the last decades. By bringing together a lot of this research and generating new ideas, this book is sure to add to further major developments in our ideas about schizophrenia."--Journal of Psychosomatic Research
American Journal of Psychiatry - Richard Warner
"Therapists and psychiatrists will discover many approaches that will be useful in working with patients with psychosis in a variety of settings and situations beyond the formal cognitive therapy session....This rich and powerful book will be valuable to anyone in the field of mental health who works with people with psychotic disorders and who would like to be able to do more to help them."--American Journal of Psychiatry
Psychological Medicine - Anand K. Pandurangi
"In its 14 chapters, the reader is treated to not only a detailed presentation of cognitive therapy and practice in schizophrenia, but also a rich overview of the disorder and current biological models that conceive of cognitive deficits as the central core of schizophrenic psychopathology....The authors make a persuasive case that, when used in conjunction with pharmacotherapy, cognitive therapy could become a key ingredient in offering hope and recovery to many patients with schizophrenia."--Psychological Medicine
Psychiatric Services - Lon C. Herman
"For graduate students, residents, current practitioners, and others seeking a single body of work to deepen their understanding of schizophrenia and treatment approaches benefitting those affected by the syndrome, [this book] is made to order....The authors are recognized leaders in promoting the cognitive model of schizophrenia and its treatment. Yet, this book goes well beyond the model by providing a concise, historic overview of how schizophrenia has been conceptualized and addressed and how contemporary biological knowledge can be integrated with the cognitive model to address this serious disorder....In developing this book, the authors clearly set a high bar with an ambitious set of objectives: providing a historical overview of schizophrenia; describing the syndrome's etiology; synthesizing theory, research, and practice; offering cognitive and biological perspectives; and providing practical advice to treatment providers. In each instance, the book has met the challenge. It is recommended for professionals across health disciplines as well as others interested in state-of-the-art treatment approaches to schizophrenia."--Psychiatric Services
Cognitive Behavioral Therapy Book Reviews - Jim Claiborn
"A comprehensive volume that is a guide to learning and applying cognitive therapy to schizophrenia. This fills a critical gap....It is exceptional in that it is filled with clinical insights and suggestions based on experience....The book is also exceptional in its clarity and depth of coverage....This book will stand as a classic leading to a generation of therapists able to bring hope and clinically important help to those suffering from schizophrenia. Beck and colleagues have completed the circle from a tantalizing case study over 50 years ago to a well formulated guide to understanding psychotic symptoms and applying cognitive therapy."--Cognitive Behavioral Therapy Book Reviews
Schizophrenia Magazine - Peggy Thompson
"The book offers detailed guidance for formulating individual cases and tailoring cognitive and behavioral interventions to meet each patient's needs....Combining cognitive therapy and pharmacotherapy, the book provides valuable advice on engaging patients who may be fearful or suspicious. It is a comprehensive and convincing reference for practitioners, including clinical psychologists, social workers, psychiatrists, psychiatric nurses, rehabilitation specialists, and graduate students."--Schizophrenia Magazine
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Product Details

  • ISBN-13: 9781606230183
  • Publisher: Guilford Publications, Inc.
  • Publication date: 10/29/2008
  • Edition description: New Edition
  • Pages: 418
  • Product dimensions: 6.40 (w) x 9.00 (h) x 1.30 (d)

Meet the Author

Aaron T. Beck, MD, is University Professor Emeritus of Psychiatry, School of Medicine, University of Pennsylvania, and the founder of cognitive therapy. He has published more than 20 books and over 540 articles in professional and scientific journals. Dr. Beck is the recipient of numerous awards, including the Albert Lasker Clinical Medical Research Award, the American Psychological Association Lifetime Achievement Award, the American Psychiatric Association Distinguished Service Award, the Robert J. and Claire Pasarow Foundation Award for Research in Neuropsychiatry, and the Institute of Medicine's Sarnat International Prize in Mental Health and Gustav O. Lienhard Award. He is President of the Beck Institute for Cognitive Behavior Therapy and Honorary President of the Academy of Cognitive Therapy.

Neil A. Rector, PhD, is Director of Research, Department of Psychiatry, Sunnybrook Health Sciences Centre, Toronto, and Associate Professor of Psychiatry, University of Toronto. He is a Founding Fellow of the Academy of Cognitive Therapy and an editorial board member of several cognitive therapy journals, and conducts research on cognitive mechanisms and cognitive therapy treatments for psychiatric disorders. Dr. Rector has an active clinical practice and is also involved in training and supervision.

Neal Stolar, MD-PhD, is a Medical Director and Director of the Cognitive Therapy for the Treatment of Psychosis Special Project at Project Transition in the Philadelphia area; a psychiatric consultant for Creative Health Services and Penn Behavioral Health; a researcher at the University of Pennsylvania’s Psychopathology Research Unit and Schizophrenia Research Center; and in private practice. Dr. Stolar is a Founding Fellow of the Academy of Cognitive Therapy. He has lectured internationally on cognitive therapy of schizophrenia.

Paul Grant, PhD, is Director of Schizophrenia Research and a Fellow in the Psychopathology Research Unit, Department of Psychiatry, University of Pennsylvania. Dr. Grant’s research interests include cognitive psychopathological models of positive and negative symptoms as well as cognitive therapy of schizophrenia. He is the author of several journal articles and book chapters.

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Table of Contents

1. Overview of Schizophrenia
2. Biological Contributions
3. A Cognitive Conceptualization of Delusions
4. A Cognitive Conceptualization of Auditory Hallucinations
5. A Cognitive Conceptualization of Negative Symptoms
6. A Cognitive Conceptualization of Formal Thought Disorder
7. Assessment
8. Engagement and Fostering the Therapeutic Relationship
9. Cognitive Assessment and Therapy of Delusions
10. Cognitive Assessment and Therapy of Auditory Hallucinations
11. Cognitive Assessment and Therapy of Negative Symptoms
12. Cognitive Assessment and Therapy of Formal Thought Disorder
13. Cognitive Therapy and Pharmacotherapy
14. An Integrative Cognitive Model of Schizophrenia
Appendices
A. Beck Cognitive Insight Scale (BCIS)
B. Scoring and Interpretation of the Beck Cognitive Insight Scale (BCIS)
C. Suggested Outline for Initial Psychological/Psychiatric Evaluation
D. Cognitive Assessment of Psychosis Inventory (CAPI)
E. Cognitive Triads for Delusional Beliefs
F. Cognitive Distortions Seen in Patients with Psychosis
G. Cognitive Distortions Specific to Psychosis
H. Thought Disorder Rating Scale (THORATS)

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