Psychotherapy in people at a high risk of psychosis and those with early psychosis

Recent years have witnessed a growing awareness of the importance of early treatment of psychosis and preventive interventions, in which psychotherapy plays an increasing role. The effectiveness of psychotherapy in preventing disease progression from prodromes to the first episode is similar to that of pharmacotherapy. The majority of collected data refer to cognitive behavioural therapy, although other, increasingly numerous therapeutic approaches are also used in the treatment of schizophrenic disorders. Dealing with the symptoms and difficulties associated with traumatic experiences, e.g. by using trauma-focused therapeutic methods, is also an important element of prevention. The first episode of psychosis is the time when intensive programs of early intervention bring the most benefit. These programs encompass various forms of therapeutic interventions, and pharmacotherapy is not always necessary. There is a growing number of reports on the use of different modalities of individualised therapy, such as cognitive behavioural therapy, "third wave therapy" - mindfulness-based therapy for psychosis (MBT), acceptance and commitment therapy (ACT), as well as metacognitive therapies, in the first episode of psychosis. Many reports indicate that family interventions clearly reduce the risk of recurrence and re-hospitalisation in early psychosis. The role of trauma, including the one associated with the disease itself and the treatment used, in the first episode of psychosis, is an important and currently developing area of research. The diagnosis and treatment of the symptoms of trauma pose difficulty for professionals, which is due to inadequate training and the lack of clinical recommendations.