Collaborative Empiricism in Cognitive Therapy for Psychosis: A Practice Guide

We outline our understanding of collaborative empiricism (CE) as used in cognitive therapy (CT) for psychosis. We discuss how CE can be thought of as a technique for facilitating cognitive change in the service of a client's goals, but also as an expression of respect for client autonomy, recognizing the ethical imperative to empower clients by involving them in decisions about their care. Taking a CE approach is therefore consistent with user-led conceptualizations of recovery, and the related movements of “shared decision-making” and “evidence-based patient choice.” We discuss how CE can aid with engagement, assessment, formulation, and intervention in CT, illustrating this with case material. We focus on how CE can help with distressing intrusive experiences and beliefs, and also consider its role in helping clients achieve wider life goals. Adaptations to CE for working with people with problems with learning, attention, and memory are discussed, as are considerations for working with high conviction and conceptual disorganization.

► We discuss collaborative empiricism (CE) in cognitive therapy (CT) for psychosis
► We review why CE is particularly important with this group
► We discuss our approach to CE in CT, illustrated using case-study material
► We focus on normalizing, evidence-gathering, and behavioral experiments
► Strategies for overcoming obstacles to using CE with this group are suggested