Online CBT for Schizophrenia: Dr. Jen Gottlieb and Brian Chiko

Cognitive Behavioral Therapy can be very helpful for people with schizophrenia, but practitioners are few and far between, and sessions can be expensive. CopingTutor.com is a new online tool to teach people who have schizophrenia clinically-validated cognitive behavioral techniques to better cope with common symptoms like voices. This month on Brain Waves, Dr. Jennifer Gottlieb, the scientist who developed the program's content, and Brian Chiko, the CEO of the program's parent company, explain how it works and how to get an account.

This segment's question and answer session is now closed. 

Comments

brian chiko's picture

Good morning everyone, We look forward to hearing your questions and doing our best to answer them. Brian

Hi Everyone -- Thanks for watching the video, happy to take your questions. Best wishes, Jen Gottlieb
Gayle A's picture

Hi-This is very exciting news. I was wondering if any patients in your study experience relief from self-harm while participating in your program? When my daughter's auditory hallucinations are at their worst, she is encouraged by one voice to self-harm. Thank you so much.
Gayle A's picture

Thank you as well. This video is very encouraging and I will be sharing this resource with my daughter's healthcare team. My daughter has been working with a CBT for a few years. Can she use this program along with face to face CBT? Thank you for all you do.
brian chiko's picture

Hi DaffodilMom, Thanks - please do share this new resource with your daughter's healthcare team. We're trying to get the word out. You can absolutely use the CopingTutor program at the same time as face to face CBT. In fact I suspect that this combination of both will allow people get the best possible outcomes. Face to face CBT therapy might be great for many people - but it can be expensive, it is typically quite infrequent (one every week or every few weeks) - and even if a person is doing face to face therapy they are still going to be getting "homework" of activities and skills to practice when they are away from the psychologist's office. The online CBT for schizophrenia program at CopingTutor is a fun and engaging way to do the practice that is required to get the most benefit out of CBT. CopingTutor is available 24 hours a day, 7 days a week so that people can watch the tutorials, and play the games and do the activities and get reminders during the times between the face to face meetings. We make the "homework" part of CBT for schizophrenia easy and engaging (even fun) so that people can get the most from this therapeutic approach. This is important because research I've seen has suggested that regular homework is associated with the best outcomes with CBT, and homework is also where people struggle the most with when doing CBT. Doing CBT exercises with paper and pen is a hassle, and generally considered boring - so people typically don't do as much as would be ideal. I think that the benefit that the face to face meetings with the CBT-oriented psychologist will provide is that individualized, and personal attention that software program are not designed to provide. With the psychologist a person can ask specific questions and get immediate answers back - which is great. So taken together this is why I think they are extremely complementary approaches that will allow people to get the best results. And don't just take it from me. We're working with a number of teams of psychologists at some of the top early psychosis intervention centers around the world who are very interested in using our software in just this manner - to augment their own services between the personal meetings that they have with people. This makes the centers more efficient and gets their clients up to speed on CBT much better, so it saves them time and money and (we believe) improves outcomes with their clients. Also, you didn't mention whether your daughter's psychologist is an expert in CBT for psychosis or schizophrenia. While there are quite a few CBT-oriented psychologists around the world, the number that are experienced in CBT for schizophrenia is extremely limited. So if the psychologist is not trained in CBT for psychosis / schizophrenia, then the CopingTutor program will provide a whole new added level of depth for people working with a generic CBT psychologist. We've worked closely with Jennifer Gottlieb, PHD who has focused for many years on doing CBT for psychosis, and who worked at the Harvard CBT for Schizophrenia program for many years - so in effect when you use the CopingTutor program you're getting access to that expertise for very low cost. Additionally, we work with many other leading psychologists who have worked for many years in the top CBT for schizophrenia programs around the world and so we're integrating the knowledge from many sources to make a program be a great starting point for people interested in help for schizophrenia. I hope this answers your question. Please feel free to follow up with more questions if I haven't explained things as clearly as I could. Brian
Gayle A's picture

Her CBT is outstanding but not an expert with psychosis/schizophrenia (she let us know when she started treating our daughter). I am very excited about sharing this program with her as well as the rest of my daughter's behavioral healthcare team. Thank you for your time with your very helpful response. And thank you, IMHRO, for giving us tremendous hope as well.
Janice's picture

Will I get a reply? My name is Janice.

Thank you for your thoughtful question. I actually did not directly assess self-harm in the evaluation for the program because I was more focused at that point on trying to understand how the program impacted some of the more basic experiences related to hearing voices (like severity of voices and the perception of how negative the voices seemed). However, what you mention about your daughter's experience with self-harm is very important, and I think that over time, as I am able to look more closely at the specific ways that the Coping with Voices program affects people's experiences with their symptoms, I can learn more about any potential positive impact that it might have on those types of problems. Certainly it would be wonderful if the Coping with Voices program could indirectly reduce self-harm.
Gayle A's picture

Thank you so much. Based on your response, and after watching the video again, I imagine the potential for reducing behaviors directed by auditory hallucinations may be impacted as well and this is very encouraging. I am excited about sharing this video/information with her healthcare providers. Thank You!
Janice's picture

Hi, I have a diagnosis of Bipolar 1. I am 62, tired educator at elementary through UC Davis lecturer. I believe mental illness is a spectrum, in that I share similarities with others that have different diagnosis. I was treated for Major Depressive Disorder for 10 yrs. Then Bipolar. I retired after 25+ years of an exemplary career on disability. I have lived the stigma and lack of understanding from family and others. I have been hospitalized, treated with many different meds. As a life long learner, I have found that I need to research as much as I can in effort to treat myself, along with psychiatrist. This can be a lonely journey, as you try to cope and put on a "normal" front, in my case, my grown children and their families. I have been left out a lot. Getting to my question, I would like to participate. At this very moment I don't have the funds to pay a fee, but hope to as I am going back to work as a substitute teacher. My thoughts play negative games with me. I lack confidence, I isolate, I am fearful. Negative thinking that is holding me back, even thwarting my best efforts to get back into life. Being intelligent, well educated with a history of success in life almost feels like a deficit! Does that make sense? Do my decades of struggling with mental illness "qualify" me for participation. Coping Tudor.com sounds like such an exciting tool to help me move out of the blocks my mind keeps putting in front of me. I hope you can respond. Thank you, Janice
Janice's picture

When to expect a reply? I assume question was received. Have not participated in forum before. Janice
brian chiko's picture

Hi Janice, Thanks for your question, and I know from people close to me that recovery can be a long and lonely journey. The efforts you're making to research as much as you can seems like a wise move. Our focus has been on applying Cognitive Behavioral Therapy techniques for psychosis, with a specific focus of helping people with schizophrenia. Bipolar disorder is, I believe, another disorder where psychosis plays a significant role, so it seems like our application might be potentially helpful for someone like you, but we have not done any testing in this area. I recommend you try the two week free trial we have on the site and learn what you can and see its helpful. Brian

Hi Dr. Gottlieb, First let me say that what you are doing is terrific. I believe you will find it to be quite successful. I'm saying that because I volunteer my time for a self-help mental health organization called Recovery International (formally Recovery Inc.) and we receive training and then practice what is referred to as the Recovery Method and find it to be very success. The Method was developed by neurophychiatrist Abraham Low back in the 1930s and is still effective today as it was back then. As a matter of fact, I believe as many others do, that it was the Recovery Method that ushered in CBT. When you spoke about patients hearing voices that would unnerve them, I thought of some spottings (as we refer to them) and one goes like this: "Hallucinations, delusions and dreams have the highest degree of reality and whenever a thing seems real, it is almost certain to be nothing but imagined." There are more simpler ones that can be used, the one I used here, is just one of many that Dr. Low has written and lectured about. I feel the Recovery Method relates to what you are saying. So, what I would like to ask you is: What are your thoughts on what I'm saying here, and do you feel in such a way that it is quite similar? Thank you, Tony Ferrigno

Thank you for your insightful comments, Tony. I've heard of Recovery, Inc (now called Recovery International, as you note above), but I can't say that I know much about the specifics of it, so I'm not sure I can directly comment about its similarities to CBT and the coping strategies suggested for those distressed by hearing voices. However, I can say that CBT in general, and specifically as it applies to helping people with schizophrenia who have upsetting symptoms like voices, is a very recovery-oriented intervention -- in that it teaches skills that empower the individual to feel more capable and effective at managing the problems that occur within this illness -- which in turn can help people move forward in their lives in a more comfortable and productive way (so that people can do things that are important to them in life). I like the quote you noted in your above post, very interesting. CBT helps people to re-evaluate some of their upsetting beliefs about their symptoms (like voices) so that they don't get stuck in one way of thinking about their experience. This can really help people think differently about their initial interpretations of their experiences (like hearing voices), and that can provide a lot of relief. Sounds like you are doing great work volunteering to help others with these sorts of problems. Thanks again.
brandon.staglin@staglinfamily.com's picture

Tony, Janice and DaffodilMom, thank you for participating in Brain Waves! I hope each of you was able to learn useful things from this session.Jen and Brian, thank you very much for your interviews and your online responses.Comments are now closed. I hope to see you all March 27-29 on Brain Waves, when 2013 Rising Star winner Dr. Phil Corlett will talk with us about his proposal for a human trial of the drug Retigabine as a potential targeted therapy for schizophrenia's delusions and anhedonia.All the best,Brandon

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