CBT involves identifying patient behaviors that
lead to unwanted outcomes (e.g., poor medication compliance);
identifying thoughts and beliefs that lead to
these behaviors (e.g., “I don’t need medications, they
never help”); identifying the distortions in those beliefs
(e.g., all-or-nothing thinking distortion such as “medication
never helps”); and gathering evidence that contradicts
unhelpful beliefs (e.g., “I am able to stay out of
the hospital when I stay on my medication; that suggests
that it helps in some way”). Patients were trained to use
this process to examine their thinking, then modify their
thoughts to increase healthy thoughts and behaviors.
The module addressed specific issues faced by older
patients with schizophrenia, including beliefs regarding
ability to change; coping with chronic medical problems;
coping with stressors (e.g., loss of role or supports);
and dealing with sequelae of long-term
neuroleptic treatment