Medication free CBT Trials and Implications for Service Delivery 
                  
                 This workshop will outline a cognitive approach to the understanding of distressing psychotic experiences, which 
                 suggests that it is the appraisal of such experiences and the responses to them that causes the associated distress 
                 and disability. The workshop will also provide an update regarding the rationale for CBT as an alternative to 
                 antipsychotic medication and examine the evidence from several of our recent randomized controlled trials, 
                 which have evaluated CBT for psychosis in people not taking medication. The workshop will use a variety of 
                 techniques including collaborative discussion, role plays and video demonstration to illustrate how this model can 
                 be used to develop idiosyncratic case formulations with service users and how such formulations are used to 
                 guide intervention. Specific issues to be covered include development of formulations, using these to derive 
                 intervention strategies, common verbal reattribution strategies, use of behavioural experiments and homework 
                 tasks (including for therapists). This will be delivered in the context of our manualised protocol that has been 
                 extensively evaluated in our randomized controlled trials. The workshop will assume knowledge of and basic skills 
                 in cognitive therapy and some experience of working with people with psychosis. Learning outcomes will include 
                 the ability to develop formulations based on the model, knowledge of how to utilise these to collaboratively 
                 select change strategies and both practice and observation of common change strategies to promote 
                 understanding of their use, as well as knowledge of the evidence base and adaptations for working with people 
                 who are not taking medication. 
                  
                 Learning objectives: 
                 Participants should be able to –  
                        Understand the rationale for the use of CT for people with psychosis 
                        Summarise the rationale and evidence base for CBT as an alternative to antipsychotic medication 
                        Develop case formulations based on a cognitive model 
                        Select treatment strategies based on such formulations 
                  
                  
                 Key References: 
                  
                 Brabban A, Byrne R, Longden E, Morrison AP. The importance of human relationships, ethics and recovery-
                 orientated values in the delivery of CBT for people with psychosis. Psychosis: Psychological, social and integrative 
                 approaches. 2016. 
                  
                 Morrison, A.P. (2001) The interpretation of intrusions in psychosis: An integrative cognitive approach to psychotic 
                 symptoms. Behavioural & Cognitive Psychotherapy, 29, 257-276. 
                  
                 Morrison, A. P., Renton, J. C., French, P., & Bentall, R. P. (2008). Think you're crazy? Think again: A resource book for 
                 cognitive therapy for psychosis. London: Routledge. 
                  
                 Morrison AP, Law H, Carter L, Sellers R, Emsley R, Pyle M, et al. Comparing antipsychotic medication to cognitive 
                 behavioural therapy to a combination of both in people with psychosis: a pilot and feasibility randomised 
                 controlled trial. Lancet Psychiatry. 2018;5(5):411-23. 
                  
                 Morrison AP, Turkington D, Pyle M, Spencer H, Brabban A, Dunn G, et al. Cognitive therapy for people with 
                 schizophrenia spectrum disorders not taking antipsychotic drugs: a single-blind randomised controlled trial. The 
                 Lancet 2014:dx.doi.org/10.1016/S0140-6736(13)62246-1. 
                  
                 Morrison AP. A manualised treatment protocol to guide delivery of evidence-based cognitive therapy for people 
                 with distressing psychosis: learning from clinical trials. Psychosis: Psychological, social and integrative approaches. 
                 2017. 
                  
                  
                 CBT approaches for personal stigma 
                  
                 This workshop will provide the most up-to-date literature regarding the personal stigma of psychosis, linking the 
                 literature to clinical practice. In particular, we shall pay attention to the variables that drive personal stigma and 
                 the psychosocial consequences. The workshop will focus on best practice regarding interventions for personal 
                      stigma based on recent systematic reviews and meta-analysis, outlining a rationale for CBT as an intervention to 
                      support people with experience of psychosis who report personal stigma.  
                       
                      Specific issues to be covered will include the CBT assessment and formulation of personal stigma and how to use 
                      these to derive intervention strategies. The workshop will focus in on the following intervention strategies: 
                      psychoeducation and normalising techniques, self-esteem, schema as self-prejudice model and survey 
                      techniques. This will be delivered in the context of our treatment manual for Cognitive therapy for internalised 
                      stigma in people experiencing psychosis (Morrison et al. 2016). Given the role of disclosure and social withdrawal 
                      in the maintenance of internalised stigma, we shall also consider approaches to addressing disclosure related 
                      concerns.  
                       
                      The workshop will use a variety of techniques including collaborative discussion, role-plays and video 
                      demonstration to illustrate how the CBT model can be applied to personal stigma in psychosis. Learning 
                      outcomes will include understanding regarding the wide reaching impact of personal stigma, the ability to 
                      recognise and assess personal stigma in people with psychosis, the ability to deliver change strategies that target 
                      personal stigma.  
                       
                      Learning objectives: 
                      Participants should be able to: - 
                                Understand the rationale for the use of CBT for people with distress associated with personal stigma 
                                 related to psychosis 
                                Cognitive-behavioural assessment of stigma 
                                Develop case formulations of internalised stigma based on a cognitive model 
                                Select change strategies based on such formulations 
                                Practice and observe application of assessment and change strategies relevant to personal stigma 
                       
                      Key references 
                       
                      Bennett-Levy, J., Butler, G., Fennell, M., Hackman, A., Mueller, M., & Westbrook, D. (Eds.). (2004). Cognitive 
                      behaviour therapy: Science and practice series. Oxford guide to behavioural experiments in cognitive therapy.  
                      New York, NY, US: Oxford University Press. 
                       
                      Brohan, E., Elgie, R., Sartorius, N., Thornicroft, G. (2010). Self-stigma, empowerment and perceived discrimination 
                      among people with schizophrenia in 14 European countries: The GAMIAN Europe study. Schizophrenia Research, 
                      122 (1), 232-8. 
                       
                      Morrison AP, Burke E, Murphy E, Pyle M, Bowe S, Varase F et al. (2016). Cognitive therapy for internalised stigma 
                      in people experiencing psychosis: A pilot randomised controlled trial. Psychiatry Research, 240, 96-102. 
                       
                      Padesky, C.A. (1990). Schema as Self-Prejudice. International Cognitive Therapy Newsletter, 6, 6-7. 
                       
                      Thornicroft, G., Brohan, E., Rose, D., Sartorius, N., Leese, M. (2009). Global pattern of experienced and anticipated 
                      discrimination against people with schizophrenia: a cross sectional survey. The Lancet, 373, 408-15. 
                       
                      Wood, L., Burke, E., Byrne, R., Enache, G., Morrison, A.P. (2016).  Semi-structured Interview Measure of Stigma 
                      (SIMS) in psychosis: Assessment of psychometric properties. Schizophrenia Research, 176, 398 – 403. 
                       
                      Wood, L., Byrne, R., Varese, F., Morrison, A.P. (2016). Psychosocial interventions for internalised stigma in people 
                      with a schizophrenia-spectrum diagnosis: A systematic narrative synthesis and meta-analysis. Schizophrenia 
                      Research, 176 (2-3), 291-303.