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số yêu cầu nó ở một mức độ cơ bản hơn và số lượng sẽ được hưởng lợi từ một đào tạo nhận thức-hành vi rộng. Khi đó một kế hoạch phát triển, có thể có một lộ trình rõ ràng về kinh phí, từng bước một lần nữa thường, nhưng thường vẫn còn cần phải được tham khảo ý kiến với các nhóm chuyên nghiệp | 220 COGNITIVE BEHAVIOUR THERAPY FOR PSYCHOSIS number that require it at a more basic level and the number that would benefit from a broad cognitive-behaviour trainIng. When such a plan is developed there maybe an obvious route for funding again usually incrementally but often there still needs to be consultation with professional groups management teams service planning committees and funding bodies with a gradual process of refinement and usually reduction of the proposals. A long-term srrategy over 3 to 5 years can allow for flexibility but enduring collaborative persistence as in CBT itself has a good chance of producing good outcomes in the end. CONCLUSIONS Implementation of CBT in psychosis can mean pushing against open doors but even where this is the case enlisting support and planning carefully is least likely to waste resources financial personnel or time. Where the door seems closed even locked it may take time to find the key but gradual enlisting of support through information and examples of clinical success can make progress even where resistance seems strongest. We have certainly found it to be worth the trouble and hope you do too. REFERENCES Adams C. Wilson P. Bagnall A.-M. 2000 . Psychosocial interventions for schizophrenia. Quality of Health Care 9 251-256. Allen J. Kingdon D.G. 1998 . Using cognitive behavioural interventions for people with acute psychosis. Mental Health Practice 1 14-21. APA 1993 . Diagnostic and Statistical Manual 4th edition . Washington DC American Psychiatric Association. APA 1998 . Guidelines on Schizophrenia. Washington DC American Psychiatric Association. Asberg M. Montgomery S.A. Perris C. 1978 . The Comprehensive Psycho-pathological Rating Scale. Acta Psychiatrica Scandinavica Suppl. 271 5- 27. Ballard C.G. Chithiramohan R.N. Bannister C. Handy S. 1991 . Paranoid features in the elderly with dementia. International Journal of Geriatric Psychiatry 6 155-157. Barham P 1995 . Manfred Bleuler and the understanding of .