Psychotherapy with patients with delusional disorder could be challenging. The first step in the schematherapy is to develop safe atmosphere; a patient needs to feel accepted, nurtured and praised. The therapist protect and nurtured Vulnerable child and helps the patient to stop Critical and Punitive parent. The patient learns how to distinguish modes during the day. Frequently, the Detached protector needs to be bypassed. Paranoid states come from and influence several modes, mostly Vulnerable child, Detached protector and Critical parent. Subsequently, the patient strengthens Healthy adult by using cognitive and behavioral strategies from classical CBT. The patient with chronic delusions gradually learns through inductive questioning to distinguish between perception and interpretation, firstly on the periphery of the delusional belief system. Then he/she learns to apply the Socratic dialogue to challenge false assumptions, provide an alternative hypothesis, and test the beliefs by behavioral experiments. The therapy includes an interconnection of delusional system with core beliefs and conditional rules that the delusional system originally arises from and now is involved in its maintenance. Our workshop aims at teaching cognitive and schematherapeutic approaches for such individuals.
Marie Ociskova, Jan Prasko, Milos Slepecky, Antonia Kotianova
Department of Psychiatry, Faculty of Medicine and Dentistry, University Palacky Olomouc, University Hospital, Olomouc, Czech Republic