Recovery-Oriented Cognitive Therapy for Serious Mental Health Challenges
Disengagement from treatment, either through drop out or minimal participation, is the best predictor of poor outcomes for individuals given serious mental health condition diagnoses (Dixon, 2009). There have been calls in the field to develop new strategies and interventions to better engage and work with individuals who may not be “help seeking” or who may find the prospect of treatment unappealing (Dixon, Holoshitz, & Nossel, 2017). Recovery-Oriented Cognitive Therapy (CT-R) has been expressly formulated to meet this need.
Guided by Aaron Beck’s cognitive model, CT-R is an evidence-based practice that provides a map and concrete steps to promote recovery and resiliency for individuals experiencing extensive behavioral, social, and physical health challenges. CT-R is highly collaborative, person-centered, and strengths-based. CT-R is applicable — and has been successfully implemented — in the very settings that attempt to provide care to individuals who have a history of feeling disconnected and distrustful of service providers: state civil and forensic inpatient units, community and specialty care teams, programmatic and transitional residences, and outpatient mental health clinics.
This 3-hour session will begin with a brief review of the research supporting CT-R formulations and strategies. Next, participants will gain an improved understanding of individuals who are reluctant to engage in treatment or who are not making much progress. This framework — a combination of Beck’s cognitive model and his theory of modes (Beck, 1963; 1996) — will enable attendees to better meet these individuals where they are at, discover the person behind the “patient,” and purposefully pursue their desired life, leading to new or strengthened resiliency beliefs that sustain progress in the face of challenges (e.g., difficulty accessing motivation or energy, being consumed by hallucinations or delusions, engaging in aggressive or self-injurious behavior). Participants will learn how to consolidate this understanding and approach by completing a CT-R Recovery Map as a group. All attendees will leave with an action plan to apply to one of their individuals.
- Apply the cognitive model to better understand reasons that individuals with serious mental health conditions do not engage with treatment
- Recognize “at best” moments and associated positive beliefs
- Identify at least 2 methods of eliciting life-aspirations along with their meanings
- Describe at least 3 guided discovery questions for strengthening positive and resiliency beliefs
- Beck, A. T., Grant, P. M., Inverso, E., Brinen, A. P., & Perivoliotis, D. (2021). Recovery-oriented cognitive therapy for serious mental health conditions. New York, NY: Guilford Press.
- Grant, P. M., Bredemeier, K., & Beck, A. T. (2017). Six-Month Follow-Up of Recovery-Oriented Cognitive Therapy for Low-Functioning Individuals With Schizophrenia. Psychiatric Services, 68(10), 997-1002. doi:10.1176/appi.ps.201600413
- Beck, A. T., Rector, N. A., Stolar, N., & Grant, P. M. (2009). Schizophrenia: Cognitive Theory, Research, and Therapy. New York, NY: Guilford Press.
- Grant, P. M., Perivoliotis, D., Luther, L., Bredemeier, K., & Beck, A. T. (2018). Rapid improvement in beliefs, mood, and performance following an experimental success experience in an analogue test of recovery-oriented cognitive therapy. Psychological Medicine, 48(2), 261-268. doi:10.1017/S003329171700160X
- Beck, A. T., Himelstein, R., & Grant, P. M. (2019). In and out of schizophrenia: Activation and deactivation of the negative and positive schemas. Schizophrenia Research, 203, 55-61. doi:10.1016/j.schres.2017.10.046