In the previous part of the article, we examined the main postulates and prerequisites for positive therapy for delusions, and also identified those “gains” that a client with schizophrenia should receive as a result of work. This article can be found at the link. The purpose of this article is to highlight the process of CBT for delirium, methods and positions. So, let's begin. The process of treating delusional symptoms within the framework of the CB paradigm is represented by the following sequence of stages: 1. Survey;2. Consideration of inciting events;3. Study of the client’s emotional and behavioral spheres;4. Study of delusional beliefs (structure of delusions); Let's consider each of the stages in more detail. ===================================== ============================================ Examination When considering delusions, it is first necessary to identify problematic situations and negative emotional behavioral reactions that the patient experiences at the same time. experiences. Having gathered sufficient information about the patient's triggering stimuli and reactions, the therapist begins to explore his thoughts, interpretations and assessment of the situation. When considering delusional thinking, specific interpretations in certain situations are first considered, and a little later the themes that form the basis of the delusion in question are assessed. In this case, as a rule, the terms “schizophrenia” and “delusion” are not used, but the patient’s delusional belief is perceived as his opinion, and these views are not considered as a sign of mental illness, as this can lead to disruption of the therapeutic relationship and termination of therapy from the patient's perspective. Consideration of precipitating events The type of events that trigger delusional thoughts often indicate psychological vulnerability of the patient in the areas of autonomy, connection with other people, and self-concept. During the investigation of these triggering stimuli and situations, the following rules should be followed: 1. It is necessary for the patient to focus on describing a specific event that caused him emotional discomfort and delusional thoughts. This event can be either external or internal (voices, feelings of control, physical symptoms);2. It is necessary to determine which situations do not cause delusional thinking in the patient, since this knowledge can help alleviate delusional thinking within the framework of therapy. When determining triggering stimuli, it should be remembered that often delusions are an attempt to make sense of extremely stressful events and experiences, for example, voices, feelings of control at a distance, etc. The patient perceives these mental experiences as evidence of the reliability of delusional explanations. Part of CBT for delusions is to look for other possible explanations for these experiences. Exploring the patient's emotions and behavior Emotions. It is necessary to pay special attention and find out exactly what feelings the patient is experiencing in a particular situation (anxiety, depression, anger), ask him to write down these emotions and determine their intensity on a simple scale (for example, 0-4). Behavior. Measuring delusion-related behavior is more complex than measuring emotions. Overt behavior caused by delusions occurs irregularly and may vary. You should ask the patient what exactly he is not doing because of his delusional beliefs, and what he would do if he stopped believing his delusion. Exploring delusional beliefs Delusion is a complex belief that has many dimensions. Main dimensions: Persuasiveness: how confident the patient is in the truth of his delirium (0-100%). When considering persuasiveness, the therapist should avoid the following mistake: telling the patient that he believes or does not believe his delusional thinking. He should be open and make an effort to clarify the situation: “You certainly believe this, but I don’t know yet. You may be right, but you may also be wrong, because every person is capable of making mistakes. Together we will try to find out how this really is.” Study of delusions: How many hours a day does the patient think about his delusions]