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Table 1 Components of CBT intervention

From: A brief CBT intervention for depersonalisation/derealisation in psychosis: study protocol for a feasibility randomised controlled trial

Psycho-education/shared formulation
 • Psycho-education about depersonalisation
 • Individualised CBT shared formulations for current pattern of depersonalisation
 • Assessing factors which influence fluctuations in severity
 • Rationale for keeping a diary for homework
 • Example of diary completion
Behavioural
 • Planning and testing impact of environmental/behavioural changes to manipulate and manage depersonalisation symptoms
Emotion regulation
 • Examining the role of emotions associated with depersonalisation
 • Identifying anxiety/distress management strategies
 • Psycho-education about grounding strategies and practice of these
Cognitive
 • Identifying unhelpful thoughts about depersonalisation
 • Cognitive restructuring—reviewing the evidence for and against unhelpful depersonalisation related thoughts
Thinking processing
 • Role of attention in maintaining depersonalisation
 • Reducing hyper-vigilance/symptom monitoring/checking behaviours
 • Acceptance and mindfulness approaches to depersonalisation
Review and relapse prevention
 • Summary of what has been learnt from the sessions
 • Depersonalisation action plan
After each session, participants will be given a small ‘homework’ task to practice techniques introduced in the session and to monitor symptoms using a diary
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