From Theory to Therapy: The Evolution and Future of CBTp in U.S. Mental Health Care

Kopelovich, Brown, & Hardy (2025), American Psychiatric Association – Focus

This narrative review in a special issue of the APA’s Focus journal traces the theoretical foundations, empirical growth, and implementation trajectory of cognitive behavioral therapy for psychosis (CBTp) in the United States. The authors highlight CBTp’s evolution from early behavioral and educational approaches into a flexible, transdiagnostic intervention incorporating cognitive, behavioral, motivational, and environmental strategies. Despite decades of empirical support and international guideline endorsement, CBTp remains underutilized in U.S. psychiatric and forensic settings due to persistent barriers like workforce training, reimbursement limitations, and integration challenges. The article reviews key federal and state implementation initiatives and delivery formats that are expanding access. The authors emphasize the critical role of multidisciplinary teams in advancing dissemination and sustaining CBTp as a core component of recovery-oriented psychosis care.

PMID: 41613750 | DOI: 10.1176/appi.focus.20250019

Please note that this article is paywalled. Please email skopelov@uw.edu or CBTecho@uw.edu for the full article.