CBT for Psychosis — MRCPsych Paper B MCQ

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ModerateSchizophrenia & PsychosisCBT for PsychosisMRCPsych Paper B

A 39-year-old man with schizophrenia experiences persistent persecutory delusions despite adequate clozapine treatment. Cognitive behavioural therapy for psychosis (CBTp) is planned. According to NICE, what is the minimum number of planned CBTp sessions?

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Correct answer: B — 16

The correct answer is B: 16 sessions. NICE recommends that CBT for psychosis is delivered individually over at least 16 planned sessions. It should follow an evidence-based treatment manual, help the person link thoughts, feelings or actions with symptoms and functioning, and relate the re-evaluation of beliefs or reasoning to target symptoms. It should also include monitoring experiences, developing alternative coping strategies, reducing distress or improving functioning. Persistent persecutory delusions despite clozapine provide a clinically appropriate context for adjunctive CBTp but do not alter the recommended minimum course. Four or eight sessions are below the NICE minimum, while 24 and 32 sessions may sometimes be clinically appropriate but are not the specified minimum.

Reference: National Institute for Health and Care Excellence. Psychosis and schizophrenia in adults: prevention and management (CG178), recommendation 1.3.7.1, 2014; reviewed 2025. https://www.nice.org.uk/guidance/cg178/chapter/recommendations