Pardon the typographical errors in the question.

I am sceptical towards such projects. I doubt if chemical imbalance in brain brain might be treated with psychotherapy. Psychotherapy can be helpful in addition NOT instead of medication treatment.

A personal communication with Max Birchwood on this topic at the IAYMH conference Brighton 2013 was very enlightening. The current thinking is that 20% of patients with psychosis may not require medication but would respond solely to CBT for psychosis. A good foundational paper in the field can be found in Chadwick P, Birchwood M. The omnipotence of voices: a cognitive approach to auditory hallucinations. Br J Psychiatry 1994;164:190-201. A more recent review on CBT in Psychosis by Tony Morrison who is a keen proponent of medication free CBT can be found in Morrison, A. P., & Barratt, S. (2010). What are the components of CBT for psychosis? A Delphi study. Schizophrenia bulletin, 36(1), 136-142. However, a more mainstream view is that we offer a holistic approach and medication allows access to psychological therapies when used carefully and within evidence based guidelines- CBT and Family Interventions are less available than medication but all are required for a proper intervention in First Episode Psychosis.

An area of keen interest is that of the Ultra High Risk group for transitioning to psychosis and the use of Omega 3 and CBT to reduce risk of transitioning. A good paper here is Stafford, M. R., Jackson, H., Mayo-Wilson, E., Morrison, A. P., & Kendall, T. (2012). Early interventions to prevent psychosis: systematic review and meta-analysis. BMJ: British Medical Journal, 346, f185-f185.

Pharmaceutical therapy for chronic psychoses has received a lot of empirical counterarguments in the recent years. You may google studies with acronyms CATIE or CUTLASS which have shown that the acceptance even of newer antipsychotics have not become better; i.e., many patients do not take such medications anyway.

A very recent Dutch long-term study by Wunderink et al. (Pubmed PMID: 23824214) has demonstrated that patient who have stopped or reduced the recommended dosis are better off in the long run than those who haven't.

What does that mean for treatment? (1) In my opinion, alternative treatments to drugs need to get more attention in research and in practice. (2) We should listen more carefully to the preferences and experiences patients have made in their course of illness. (3) A one size fits all approach does not work; some patients benefit from a drug treatment but others don't. (4) A new approach might be to help patients finding out what they prefer and what is best suited to cope with their current life.

This is an interesting question...

I used to favour the idea of the minimum dosage of a anti-psychotic to alleviate the more 'floridly' psychotic symptoms in conjunction with therapy that is most suited for that individual.

However, two particular books that have radically changed and inspired my view on such phenomena are:

"Learning from the Voices in My Head (TED Books)" by Eleanor Longden

and

"Psychosis: Stories of Recovery and Hope [Paperback]" by Hannah Cordle (Author, Editor), Jerome Carson (Editor), Paul Richards (Editor).

These books really do highlight the importance of interpersonal therapy over all other forms of pharmacological intervention. I highly recommend you read Eleanor's book. A true inspiration and critical look at the mainstream approach to psychiatry.

On the other hand of course, having spent several years working on an NHS psychiatric ward, it would be extremely unethical and dangerous not to provide someone with an anti-psychotic, especially when they are in an heightened state of paranoia ideation. No amount of talking therapy can sufficiently help with people who are floridly psychotic!

Carl Jung had an extended psychotic period in his life that he resolved in a natural way.  He was and extraordinary individual and the father of analytical psychology.  See "The Red Book" for more information on his journey with the unconscious.

Healing schizophrenia : using medication wisely /

Watkins, John, 1951-, 2006

This is a well balanced book which made a lot of sense to me.From my experience and what I have read during my time as an RMN is that this is a mixed bag. I have seen people who experience psychosis in relation to brain changes caused by e.g head injury/,dementia,;others who experience psychosis as a result of chemicals e.g drug use;I knew someone who experienced  paranoia after eating pot noodles ; people who experience psychosis in relation to physical illness i.e delirium but I am also convinced that people experience psychosis in relation to psychological trauma. I think that sometimes these causes overlap which makes it even more complex so some one experiencing or prone to psychosis because of brain injury may have this exasperated due to distress /anxiety /psychological trauma. so psychological therapy has the potential to help someone with psychological trauma or help someone with an underlying  physical cause of the psychosis by enabling coping/reducing anxiety that would exasperate psychosis. 

My experience of medication is that it has unwanted side effects that can be crippling. but I have seen people come off medication and end up with no quality of life at all. I have seen people someone acutely unwell and tortured responding to medication and regaining a peace of mind to the extent that with holding medication  appears to be verging on cruelty. To be honest I don't know and there are a multitude of very different opinions and research findings out there . Its a case of trawling/ searching the literature with honesty and an open mind .      

In terms o

Jenny,

I agree that psychological therapy has the potential to help replace psychological trauma, with a new paradigm for copying/reducing anxiety, when exacerbating psychosis; however, overcoming psychosis initiated through a physical (say a head injury, dementia, or multiple concussions) or genetic cause (for example, schizophrenia, bipolar disorder, or temperament) is "the straw that breaks the camel's back", and I do not think that can be helped except through medication, psychological therapy, and minimizing stress levels to avert triggers that lead these sufferers to the expression of psychosis.

From my research and readings of the various viewpoints of differing psychiatrists, some conclude that a little amount of medication during the initial onset of psychosis is therapeutic and can be beneficial for the treatment of psychosis in short term.

However, a longer term study of 20 years of 137 patients showed positive outcomes for the patients who deferred from antipsychotic use (http://psychrights.org/research/digest/nlps/HarrowJobePsychMedMarch2014.pdf). The study did not focus on the ways and forms each individual patient attempted in their own independent attempts to recover from schizophrenia and psychosis, leading to a more plausible explanation of the interventions found in alternative treatments such as empathetic care, psychotherapy, lifestyle changes involving diet, routine, and exercise, and support groups (a possible one is the Hearing Voices Network). It would seem reasonable to conduct further assessments in order to verify these findings, hopefully more psychiatrists are willing to examine the data and the possible field of treatment without pharmacological interventions in the near future.

What an interesting read of answers.

I am currently involved in a Soteria project in Bradford, UK; it is based on the research of Loren Mosher - http://www.moshersoteria.com/

The idea has been to set up a 'Soteria House' in the UK based on the windhorse model.  Over the last 6 months the house has been set up and has successfully supported two individuals through an episode of psychosis, with the limited use of medication.  It is a great project and I firmly believe it will help drive the mental health system forward in the future, that's not to say medication doesn't play an important part in an individuals recovery, it does.  However, medication can only do so much.

Soteria is a project in the early stages but I feel it is an area that needs further research and funding.  The benefits of minimal medication therapies/interventions for patients are phenomenal and these need to be recognised. Further reading: http://soterianetwork.org.uk/index.php

There is also a good systematic review of Soteria which can be found here: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2632384/

Article Beyond Clinical Remission in First Episode Psychosis: Though...

I recommend an eclectic approach to psychological therapies. Hard and genuine, critical examination of the environmental factors eliciting the individual's way of coping, by the patient, and retraining the traumatic damage which incurred the current behavior into more successful ways of coping by learning to protect one's vulnerability through painful but necessary action on fears that have caused unconscious repression of expression. This requires focused changes in behavior with the ultimate goal being to develop new neural connections to override entrenched hard wired behaviors. It can take a lifetime, or half a lifetime but the dividends are priceless.

Remember to treat a person, not a theory.

I have treated a person. Myself.

To treat oneself is, of course, the most important thing. When the time comes that you want to extend the experience to also treat others, you will probably find that what works for one person doesn't necessarily work for another, That's when it becomes important to keep all reasonable options open.

Absolutely

Not sure about other pathologies, but schizophrenia, that too, paranoid type with late onset is really unmanageable because; patients feel that they don't have any problem, so they don't take medicine, they don't follow instructions or better to say that they don't want to be treated by any means, and if you force them they become delusional.