What Keeps Psychosis Going?

The What Keeps Psychosis Going? handout presents key factors that maintain psychosis.

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Professional version

Offers theory, guidance, and prompts for mental health professionals. Downloads are in Fillable PDF format where appropriate.

Client version

Includes client-friendly guidance. Downloads are in Fillable PDF format where appropriate.

Editable version (PPT)

An editable Microsoft PowerPoint version of the resource.

Overview

The "What Keeps It Going?" series is a set of one-page diagrams explaining how common mental health conditions are maintained. Friendly and concise, they provide an easy way for clients to understand at a glance why their disorders persist, and how they might be interrupted.

What Keeps Psychosis Going? is designed to help clients with psychosis understand more about their condition.

Why Use This Resource?

Understanding what keeps psychosis going is crucial for effective intervention. By identifying these factors, therapists can develop idiosyncratic models of clients' experiences and focus their interventions.

Highlights and explains key factors that maintain psychosis.
Provides a visual model that to facilitate discussion and inform case conceptualization.
Helps clients better understand the difficulties they are experiencing.

Key Benefits

Insight

Provides insights into what perpetuates psychosis.

Guidance

Serves as a roadmap for therapeutic discussions and formulations.

Understanding

Helps clients comprehend their difficulties and the ways to address them.

Engaging

Simplifies complex ideas and explanations, enhancing understanding and communication

Who is this for?

Psychosis

Designed to help clients affected by psychosis.

Integrating it into your practice

Introduce

Explain to the client that certain difficulties persist due to cycles that maintain them.

Discuss

Use the handout to discuss what might be keeping the client's difficulties going.

Identify

Pinpoint and personalize maintaining factors that are relevant to the client.

Strategize

Explore how these maintaining cycles can be interrupted.

Theoretical Background & Therapist Guidance

Psychosis is associated with a wide spectrum of experiences, including hearing voices or sounds that no-one else can hear, holding unusual beliefs that other people do not share, and struggling to think or concentrate.

Research studies have shown that cognitive behavioral therapy (CBT) is a helpful psychological therapy for psychosis. CBT therapists work a bit like firefighters: while the fire is burning they’re not so interested in what caused it, but are more focused on what is keeping it going, and what they can do to put it out. This is because if they can work out what keeps a problem going, they can treat the problem by ‘removing the fuel’ and interrupting this maintaining cycle.

In 2001, clinical psychologist Anthony Morrison published a model of psychosis which describes some of the ‘parts’ that keep psychosis going. The What Keeps Psychosis Going? information handout describes some of the key factors which act to maintain psychosis. It illustrates them in a vicious cycle or 'flower' format in which each ‘petal’ represents a separate maintenance cycle. Helping clients to understand more about these processes is an essential part of cognitive therapy for psychosis. Therapists can use this handout as a focus for discussion, or as a template from which to formulate an idiosyncratic model of a client’s experiences.

What's inside

Introduction and overview of psychosis.
Guidance for introducing the resource to clients.
Template for developing personalized maintenance cycles.
Key references for learning more about psychosis.

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FAQs

It can serve as a discussion point and a template for creating personalized formulations, helping clients understand what maintains their difficulties.

Introduce it as a framework for gaining a deeper understanding of their difficulties and the reasons why they persist.

Use it as a starting point to explore unique factors that are specific to the client's experience, and tailor the diagram accordingly.

How This Resource Improves Clinical Outcomes

This resource aims to:

Increase insight into the processes maintaining clients' difficulties.
Support collaborative formulation and treatment planning.
Present key information in a structured, understandable format.

Therapists benefit from:

A clear framework that helps explain why problems persist.
A visual tool to enhance communication and understanding.
An adaptable resource that can be tailored to clients' unique exp

References And Further Reading

Beavan, V., Read, J., & Cartwright, C. (2011). The prevalence of voice-hearers in the general population: a literature review. Journal of Mental Health, 20(3), 281-292.
McGrath, J. J., Saha, S., Al-Hamzawi, A., Alonso, J., Bromet, E. J., ... & Kessler, R. C. (2015). Psychotic experiences in the general population: a cross-national analysis based on 31,261 respondents from 18 countries. JAMA psychiatry, 72(7), 697-705.
Morrison, A. P. (2001). The interpretation of intrusions in psychosis: an integrative cognitive approach to hallucinations and delusions. Behavioural and Cognitive Psychotherapy, 29(3), 257-276.
Morrison, A. P. (2017). A manualised treatment protocol to guide delivery of evidence-based cognitive therapy for people with distressing psychosis: learning from clinical trials. Psychosis, 9(3), 271-281.
National Collaborating Centre for Mental Health (2014). Psychosis and schizophrenia in adults: treatment and management.