People experiencing psychosis who are deemed treatment resistant are not always given access to evidence-based psychological therapies, in particular cognitive behaviour therapy (CBT). It has been suggested that CBT has many benefits for people experiencing psychosis, yet it is not always effective due to entrenchment of beliefs.

This article uses a case study approach to increase awareness of CBT skills, particularly cognitive exploration and reappraisal with delusional material, to support mental health practitioners in their work with this client group. It describes assessment, formulation and techniques using CBT for psychosis (CBTp) with a service user, focusing on cognitive interventions used with delusional beliefs. Findings include a marked reduction in psychopathology, indicated via clinical measures and self-report. These results challenge notions associated with psychosis chronicity and illustrate how cognitive interventions can reduce service user distress.