Cognitive restructuring in the treatment of psychotic symptoms in schizophrenia: A critical analysis

This article reviews the 15 empirical studies that have used cognitive restructuring in the treatment of schizophrenia, more specifically for psychotic symptoms (delusions and hallucinations). Three elements are considered before investigating its effectiveness: (a) if subjects are reliably diagnosed with schizophrenia with chronic course and severe impairment; (b) if psychotic symptoms are adequately measured; and (c) if designs are methodologically sound. Our investigation revealed that schizophrenia is not reliably diagnosed and severity is low to moderate. Assessment of psychotic symptoms is satisfactory, but assessment of generalization to other areas is limited. Only five studies possess reliable design and are performed with schizophrenia subjects. These studies suggest that cognitive restructuring is effective to reduce or eliminate hallucinations or delusions in schizophrenia patients.