Cognitive Behaviour Therapy has a good track record of being able to achieve meaningful change for many disorders, among them schizophrenia. In this presentation we would like to present three cases of patients with a diagnosis of severe or chronic or treatment-resistant schizophrenia and how the creative and innovative use of cognitive behaviour therapy strategies achieved meaningful change. In all cases detailed pre and post treatment data will be presented. Detailed sessions narratives will be presented as well as creative adaptions of standard CBT techniques.

The setting of therapy is a low secure psychiatric hospital in England. Patients have been in psychiatric care for at least 15 years.

Case 1: 'I need to learn to become immune to water'

A case of not washing as a result of a waterphobia.

Case 2: 'Life is unfair, but I am making the best of it'.

Physical handicaps in combination with paranoid schizphrenia make life unfair and anger provocing for this patient. Will cognitive behaviour therapy be bale to help?

Case 3: When I feel afraid; I have to do something that scares me.

For this patient with paranoid schizophrenia, feeling anxious results in doing very scary things. Can he learn to become less vulnerable to anxiety with CBT?

All cases will be briefly presented with a focus on the results achieved AND the adaptations needed to standard cognitive behaviour therapy in order to achieve these results.