Cognitive Behavioral Management of Delusional Disorder: A Clinical Case Study

Abstract

This case illustrates the psychological management of Delusional Disorder with Cognitive Behavioral Therapy. Assessment was done informally through Clinical Interview, Dysfunctional Thought Record, Subjective Rating of the Symptoms, Mental State Examination, and formally through the Brown Assessment of Beliefs Scale (BABS). Client scored 20 on BABS (2 points higher than its cut-off score of 18) which showed significant presence of Delusional Disorder. According to DSM-5 (considering client’s symptoms, results of her psychological assessment, duration of her illness and her daily life functioning), M.F. was diagnosed with 297.1 (F22) “Delusional Disorder, Persecutory type with bizarre content”.Psychotherapeutic intervention was comprised of Cognitive Behavioral Therapy (psycho-education, relaxation exercises, cognitive re-structuring through A-B-C model, verbal challenging, evidence for and against, assertiveness training and stress management techniques) which resulted in marked improvement in client’s symptoms. Client reported 80% improvement in her delusional beliefs and it was also confirmed by the psychological assessment done at pre and post level of therapy. The score was 6 on BABS after her therapeutic intervention which falls in the category of no significant delusions.