Targeting symptoms of psychosis

Dr Ryan Balzan

A novel psychological treatment to reduce the severity of delusional episodes experienced by people with psychosis is being trialled in a new Flinders University study.

Cognitive psychologist Dr Ryan Balzan is recruiting up to 50 people with psychosis Adelaide-wide to test the effectiveness of metacognitive training to target underlying “cognitive biases”, or irregular thinking and reasoning strategies.

Evidence from Dr Balzan’s previous studies has shown that cognitive biases cause and maintain delusional beliefs so by targeting these biases, he said the severity – that is the amount of conviction the person has in the delusion and the distress it causes them – should be reduced.

“A common cognitive bias in psychosis is the ‘jumping to conclusions’ bias, where people make definite decisions on the basis of very limited information or evidence,” Dr Balzan, a Vice-Chancellor’s Postdoctoral Research Fellow in the School of Psychology, said.

“For example, a person with psychosis might catch their neighbour looking at them strangely and use that as sufficient evidence to support the belief that their neighbour is an intelligence agent,” he said.

“We know from previous research that people with psychosis tend to over-rely on these and other biased thought patterns and reasoning strategies, and we believe this is what leads to, and sustains, their delusions.”

Dr Balzan said study participants will undertake a series of one-on-one metacognitive training modules over four weeks, with a key aim of the therapy to encourage clients to “think about their thinking”.

“Metacognitive training helps clients to understand how cognitive biases may explain their beliefs, and offers them strategies to overcome them.

“For instance, in the ‘jumping to conclusions’ module, we encourage clients to delay making definite judgement decisions until they have the full picture.”

As part of the study, some participants will be randomly allocated to a second group to explore the benefits of a “cognitive remediation” computer program to reduce the neuropsychological symptoms of schizophrenia, including memory, language and attention deficits.

Dr Balzan said he hypothesised a “double dissociation”, whereby patients allocated to the individual metacognitive sessions will see a reduction in the severity of delusions, and participants in the cognitive remediation will demonstrate greater improvements in neuropsychological domains.

“We hope our findings will assist clinicians to select the most appropriate psychological intervention for their client’s symptoms.”

Dr Balzan said the two psychological approaches could be useful adjunct therapies to complement existing drug-based forms of treatment.

“While medication can reduce the severity of symptoms, a lot of people are still left with residual symptoms, which is essentially what we’re targeting.”

Dr Balzan has just received one of Flinders Vice-Chancellor’s Awards for Early Career Researchers, an annual initiative to recognise, reward and promote researchers who have made an outstanding contribution to research at the University.

For more information about the study, contact Dr Balzan on (08) 8201 3082 or email

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