Exploring types of therapy for psychotic disorders

Psychotic disorders are a group of mental health conditions characterized by losing touch with reality. Some common examples of conditions in this category include schizophrenia, schizoaffective disorder, and delusional disorder. 

Despite the myth that only medication is effective for psychotic disorders, research shows that therapy can be helpful as well. Specialized therapy methods for psychotic disorders can help you reduce your stress levels (and therefore your risk of having a psychotic episode), engage healthy coping skills, and reframe the anxious or fearful thoughts that may come along with symptoms of psychosis.

Can therapy help manage psychotic disorders?

Psychotic disorders are chronic conditions, which means they can’t be “cured” completely. But, with treatment, many people with psychotic disorders stop experiencing symptoms or experience fewer or less severe symptoms.

The most effective treatment for psychotic disorders usually involves a combination of medication and therapy. Medication can help with the brain differences that psychosis can come with, while therapy can help you:

• Improve your relationships
• Learn new ways of managing psychosis symptoms
• Adapt better to daily living tasks
• Cope with stress and other intense emotions
• Change your behaviors to prevent psychotic episodes from happening (such as avoiding substance use and getting enough sleep)
• Learn more about psychosis and how it affects your brain

Whether symptoms are best treated with medication, therapy, or a combination of both typically depends on your unique history, symptoms, and preferences. 

Most of the time, medical professionals will recommend starting with therapy — especially for people experiencing their first psychotic episodes or for children. If therapy alone doesn’t work to completely manage your symptoms, they may recommend that you try medication as well.

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Best types of therapy for psychotic disorders

Several types of therapy can help treat psychotic disorders. These include:

Cognitive behavioral therapy for psychosis (CBTp)

Cognitive behavioral therapy for psychosis (CBTp) is a structured and modified approach to CBT specifically designed to support people who live with psychotic disorders. Research shows that up to 65% of people who receive CBTp experience less intense psychotic symptoms. 

One of the core principles of CBTp is the stress-vulnerability model, which highlights how people are at higher risk of having psychotic episodes when they’re under high levels of stress. It can also become a vicious cycle because psychotic episodes can be a source of severe stress themselves. So a big part of CBTp is helping you learn how to manage stress levels in a healthy way.

CBTp can also help you examine your behaviors and thoughts and figure out if these are the most helpful ways to solve a problem. If the way you’re acting or thinking about a problem is causing you trouble, a CBTp therapist can help you to reframe those thoughts and change your behaviors.

Family intervention

Family support has also been shown to be very important in psychosis therapy. Family intervention directly supports the stress-vulnerability model of psychosis. The therapist works with the family to identify the dynamics that might be contributing to stress. 

This approach can help families improve communication and develop supportive coping strategies. Family intervention emphasizes collaboration rather than blame and recognizes families as essential allies in caring for someone with a psychotic disorder.

Beyond supporting the person with psychotic disorder, family intervention also acknowledges the needs of family members. It provides education about the condition, helps caregivers manage their own distress, and equips them with strategies to navigate challenges more effectively. 

Compassion-focused therapy (CFT)

Compassion-focused therapy (CFT) focuses on helping people deal with shame and self-criticism and work toward self-compassion, internal safety, and self-acceptance. This approach recognizes that people with psychotic disorders often come from traumatic backgrounds, and they may also be dealing with high levels of societal stigma due to their condition itself. 

CFT for psychosis is based on the idea that our brains are wired to detect and respond to threats, which can shape how we relate to ourselves, others, and even distressing voices (auditory hallucinations in psychosis). CFT aims to shift people out of these threat-based systems and into more compassionate systems. 

CFT helps people build self-compassion through practices like soothing breathing and compassionate imagery. This approach recognizes that healing requires gradually learning to feel safe in the care system, rather than reinforcing survival-based defenses.

CFT is usually done in a group setting, and research has found that it’s effective and feasible after 6 sessions. 

Body-oriented therapies

Psychotic disorders can come with an array of symptoms. There may be observable symptoms, like hallucinations, delusions, or agitation. There may also be symptoms that represent an absence of things, such as a flat affect or total lack of emotional expression.

Research shows that body-oriented therapy methods can be helpful for psychosis — especially for symptoms like flat affect. These therapies, such as creative arts and yoga, can increase body awareness and increase emotional expression. They can help you feel more grounded in the present moment and connected to reality.

Getting started with psychosis-supportive therapy

If you think you may be living with a psychotic disorder, tell a medical professional right away. You can let your family doctor know, and they’ll ideally refer you to specialized mental health treatment. If you’re already working with a therapist, tell them about the symptoms you’ve been having. They can walk you through your treatment options and make recommendations. If psychosis is outside of their area of expertise, they can connect you with someone who can help.

Being vulnerable and talking with someone about your psychosis symptoms can be scary — especially if you’re already feeling frightened by your symptoms. You may feel like you can’t trust anyone. But these mental health professionals aren’t here to harm or judge you. They just want to help you find relief. 

One of the main barriers to treatment for psychotic disorders is ending treatment early — up to one third of people with psychotic disorders don’t stick with their treatment plans. It can be difficult to adhere to your treatment plan, but if you’re having any doubts or are experiencing uncomfortable side effects, talk to your treatment provider. It can be dangerous to stop treatment on your own.

Find care with Rula

Living with a psychotic disorder can be distressing and scary. Fortunately, these conditions can be treated, and you can learn to effectively manage your symptoms and improve your quality of life. Research shows that therapy is helpful for psychotic disorders — especially alongside medication. 

At Rula, we’re committed to delivering a comprehensive behavioral health experience that helps people feel seen and understood so they can get back to feeling their best. 

Rula makes it easier to find a licensed therapist or psychiatric provider who accepts your insurance so you don’t have to choose between affordable care and excellent care. With a diverse network of more than 10,000 providers, 24/7 crisis support, and appointments available as soon as tomorrow, we’re here to help you make progress — wherever you are on your mental health journey.

Get started with Rula today