Cognitive group therapy for paranoid schizophrenics: applying cognitive dissonance

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Joseph Levine M.D. M.Sc1, Yoram Barak M.D.2 and Ilana Granek M.A.2

Psychotherapy with paranoid schizophrenics is a hard and often unrewarding task. Individual and group therapies are usually supportive and not aimed at changing the paranoid mode of thinking. Although cognitive therapy has been applied in schizophrenic patients it has not gained wide acceptance.

Cognitive dissonance postulates that individuals experience discomfort and tension when holding two dissonant beliefs simultaneously. We present group therapy of six schizophrenic paranoids treated by modified cognitive group therapy implementing cognitive dissonance as the vector of change. A control group of six age and sex matched paranoid schizophrenics were treated by supportive group therapy. Analysis of results, using the PANSS, during therapy and at follow   up of four weeks demonstrates; statistically significant improvement of total PANSS score and positive symptoms subscale.

We call for further studies implementing cognitive dissonance strategies in the treatment of psychotic patients.

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