People with schizophrenia have maladaptive thinking and distorted perceptions and so Cognitive Behavioural Therapy (CBT) aims

to change the way sufferers think about these symptoms. The term CBT is an umbrella term that incorporates several different adaptations of therapy. One adaptation is Coping Strategy Enhancement (CSE). This aims to teach individuals to develop and apply effective coping strategies which will reduce the frequency, intensity and duration of psychotic symptoms and alleviate the accompanying distress. There are two components to CSE. 1. The first is Education and Rapport Training - the therapist and client work together to improve the effectiveness of the client's own coping strategies and develop new ones. For example, Tarrier introduced the use of distraction and concentrating on a specific task to attempt to focus the mind away from the hallucinations. 2. The second component of CSE is Symptom Targeting - this is where a specific symptom will be selected for which a particular coping strategy can be devised. For example, if the client finds hallucinatory voices particularly distressing a coping strategy could be to turn up the volume on the TV or to talk more loudly in order to drown out the voices in the individuals head. In support Tarrier conducted a controlled trial in which he found significant alleviations of positive symptoms in a CSE group as opposed to a non-treatment group and also a significant improvement in the effective use of coping skills. This clearly shows that CSE provides an effective way of helping people with the disorder to control their symptoms. However out of Tarrier's original sample of 49 people, 45% dropped out during the trial. This undermines the validity of the study as the remaining sample may no longer have been representative for all schizophrenics. For instance, the remaining participants may have been the ones who had the worst (or least severe) cases of schizophrenia. Another adaptation of CBT is Beck and Ellis' cognitive therapy. This therapy aims to challenge the irrational beliefs that schizophrenics have by putting them to a reality test. The therapist asks for evidence to support a particular delusion and then encourages the client to generate alternative, more plausible explanations. In support Chadwick reported a case of an individual who believed he could make things happened simply by thinking them. He was then shown paused video recordings and was asked what would happen next. In over 50 trials he didn't get a single prediction correct and was therefore able to understand that he did not possess this influential ability. This clearly shows that by a therapist simply challenging a patient's beliefs they are able to see their deluded views and furthermore the patient is able to re-connect with reality.