Despite neuroleptic medication, many schizophrenic patients continue to experience residual positive psychotic symptoms. These residual symptoms cause distress and disability. We report a controlled trial of two cognitive-behavioural treatments to alleviate residual hallucinations and delusions. Forty-nine patients were recruited into the trial, of whom 27 entered the trial and completed post-treatment assessment, and 23 were reassessed at six-month follow-up. Patients were randomly allocated to either coping strategy enhancement (CSE) or problem solving (PS). Half the patients were allocated to a high-expectancy positive demand condition and half to a counter-demand condition to evaluate expectation of improvement. Patients receiving either cognitive-behavioural treatment showed significant reductions in psychotic symptoms compared with those in the waiting period, who showed no improvement. There was some evidence, although equivocal, that patients receiving CSE improved more than those receiving PS. There was no evidence that improvements generalised to negative symptoms or social functioning, nor was there evidence that expectancy of treatment benefit contributed to the treatment effect.

Jealousy as a clinical problem has received little attention in the psychiatric and psychological literature. Recently the literature on morbid jealousy has been reviewed and the concept placed within a cognitive-behavioral framework (Tarrier, Beckett, Harwood, & Bishay, 1990). The term morbid jealousy is used to signify an excessive irrational preoccupation with the partner’s fidelity for which there is no objective foundation. Normal jealousy can therefore be defined as a jealousy reaction occurring when the partner is unfaithful. Cognitive therapy is a therapeutic approach based on a model of psychopathology that identifies distortions of thought processes as important in emotional disorders (Beck, Rush, Shaw, & Emery, 1979; Beck & Emery, 1985). This paper describes a cognitive approach to treating the problem of morbid jealousy.