Cognitive Behavioral Therapy for Psychosis (CBTp)

  1. Home
  2. Cognitive Behavioral Therapy for psychosis (CBTp)


“…I was initially daunted by all the training requirements. It was kind of like a class, and I definitely had to do some readings and prep at home. But it paid off big time. The changes I saw my client make were incredible…the fidelity feedback far exceeded my expectations.”

“The ECHO Clinics made the difference for me. The training was great but I never would’ve been able to learn CBTp without the ECHO Clinics…just hearing other people struggling with the same thing…I learned so much from the feedback they got.”

How does Cognitive Behavioral Therapy Help with Psychotic Symptoms?


Fact Sheet on CBTp


Addressing an Unmet Need in the Pacific Northwest

Cognitive Behavioral Therapy for psychosis (CBTp) is a time-limited, solutions-focused, structured form of talk therapy that is indicated for individuals who experience distress related to psychotic symptoms.1 CBTp is not a new intervention. In fact, its evidence base spans over 30 years, and it has been studied in more than 50 randomized clinical trials, more than a dozen meta-analyses, and 4 systematic reviews.

Faculty with our center contributed to the most recent systematic review2, which reinforced support for the continued indication of CBTp to address primary psychotic symptoms and secondary mood symptoms. In recognition of the mounting evidence base, CBTp has been recommended by national psychosis treatment guidelines in the US since they were first developed by the American Psychiatric Association in the 1990s.3,4

Unfortunately, CBTp is not widely available in the US. Nationally, it’s estimated that only 0.1% of all licensed clinicians in the United States are trained in CBTp.5 As a result, few Americans are able to access a treatment that is not only intended to be part of standard care, but can address the functional stagnation that occurs without proper attention to values-based, person-centered, and skills-based care.

In recognition of the discrepancy between best and implemented practices, SAMHSA convened a panel of experts in CBTp in 2019. The meeting, chaired by Dr. Kopelovich, identified key barriers to implementation; opportunities to motivate clinicians, administrators, payers, and policymakers to routinely offer CBTp; and strategic implementation and policy recommendations to advance this mission. In 2021, SAMHSA published the written product of this meeting, which can be freely accessed on the SAMHSA website:

Understanding the magnitude of this crisis and science-to-practice gap, the Division of Behavioral Health and Recovery with the Washington State Health Care Authority (HCA) have partnered with SPIRIT since 2014 to systematically implement and disseminate CBTp across publicly-funded behavioral health settings.6,7

In addition, critical innovations, adaptations, and evaluation of empirically-supported implementation strategies have been supported by generous philanthropy. As a result of combined public-private funding, the UW CBTp Implementation Team at SPIRIT developed the first ECHO clinics8 in the world that focused on treating individuals with psychosis and is home to the first and only CBTp Provider Network in the country. Our team supports more than 300 providers across 20 counties in the Northwest region of the United States and we have provided introductory training to thousands of students, trainees, and practitioners around the globe. We offer opportunities for both in-person and virtual training in CBTp and CBTp-informed care throughout the year. To learn more about open enrollment training opportunities, click here: UW-SPIRIT-CBTp-Training-Opportunities.

In addition to our work in the Pacific Northwest, we also support the SAMHSA-funded Northwest Mental Health Technology Transfer Center (NW-MHTTC), which has a national focus on evidence-based practices for individuals with serious mental illness, including CBTp. You can use these links to learn more about our focus on CBTp as well as see a list of Northwest MHTTC training resources:



1 O’Connor, K. (2021). Psychotherapy Said to Be Key to Successful Psychosis Treatment. Psychiatric News, 56(7).

2 McDonagh, M., Dana, T., Selph, S., Devine, E. B., Cantor, A., Bougatsos, C., Blazina, I., Grusing, S., Fu, R., Kopelovich, S. L., Monroe-DeVita, M., & Haupt, D.W. (2017). Treatments for Schizophrenia in Adults: A Systematic Review. Comparative Effectiveness Review No. 198. (Prepared by the Pacific Northwest Evidence-based Practice Center under Contract No. 290-2015-00009-I.) AHRQ Publication No. 17(18)-EHC031-EF. Rockville, MD: Agency for Healthcare Research and Quality. Retrieved from  doi: 10.23970/AHRQEPCCER198 . PMID: 29537779

3 American Psychiatric Association. (1997).
Practice guideline for the treatment of patients with schizophrenia. Am. J. Psychiatry, 154(4), 1-63.

4 American Psychiatric Association. (2004). Practice guideline for the treatment of patients with schizophrenia. Am J Psychiatry, 161(2), 1-57.

5 Kopelovich, S. L., Nutting, E., Blank, J., Buckland, H. T., & Spigner, C. (2022). Preliminary point prevalence of Cognitive Behavioral Therapy for psychosis (CBTp) training in the US and Canada. Psychosis, 1-11.

6 Kopelovich, S. L., Strachan, E., Sivec, H., & Kreider, V. (2019). Stepped care as an implementation and service delivery model for cognitive behavioral therapy for psychosis. Community mental health journal, 55(5), 755-767.

7 Kopelovich, S., Monroe-DeVita, M., Hughes, M., Peterson, R., Cather, C., & Gottlieb, J.  (2018). Statewide implementation of cognitive  behavioral therapy for psychosis through a learning collaborative model. Cognitive and Behavioral Practice, 26(3), 439-452. doi: 10.1016/j.cbpra.2018.08.004

8 Kopelovich, Sarah L. PhD; Blank, Jennifer BA; McCain, Chris BS; Hughes, MacKenzie MA; Strachan, Eric PhD. Applying the Project ECHO Model to Support Implementation and Sustainment of Cognitive Behavioral Therapy for Psychosis. Journal of Continuing Education in the Health Professions 44(2):p 137-142, Spring 2024. | DOI: 10.1097/CEH.0000000000000511


Washington State Health Care Authority

Private Philanthropic Support through the Cognitive Behavioral Therapy Psychosis (CBTp) Program Fund and the Professorship of Cognitive Behavioral Therapy for Psychosis

World Schizophrenia Day

Dear SPIRIT Community, As we come to the end of Mental Health Month, we aim to recognize and destigmatize psychosis in all its forms. May 24th is World Schizophrenia Day, a time dedicated to raising awareness and promoting care for this mental illness that affects 1...
Letter blocks spelling out "Mental Health with a leaf on the side

New Publication Alert!

A recent article published in APA PsycNet discusses the role of psychologists in Coordinated Specialty Care (CSC) teams for early psychosis care, and presents a suggested model for implementation. It considers current challenges for CSC teams and proposes 4...

New Publication Alert!

The Journal of Continuing Education in the Health Professions published our analysis of the first application of Project ECHO's model to psychological treatment and the treatment of psychosis. Here we report out on the CBT ECHO Clinic model and learner and...

Featured Podcast: The Science and Experience of Cognitive Behavioral Therapy for Psychosis

APA's Medical Mind Podcast is a podcast about innovation in mental health care from the American Psychiatric Association. Dr. Sarah Kopelovich joined this special episode of The Medical Mind and discussed the science behind Cognitive Behavioral Therapy (CBT). To learn...

Talk Therapies Take On a Vital Role in Treating Schizophrenia

A March 2023 issue of Scientific American features an article by Professor Matthew Kurtz of Wesleyan University on the role of Cognitive Behavioral Therapy in treating medication-resistant symptoms of schizophrenia. The full article can be accessed here.
Translate »