Psych Ascend is proud to bring the invaluable clinical expertise of Professor Michael Garrett to Australian audiences. In a series of four dynamic 2-hour seminars, participants will delve into the integration of cognitive-behavioral therapy and psychodynamic techniques—an approach that provides a compelling and effective framework for supporting individuals living with psychosis.

In an exciting and rare opportunity for Australian audiences, attendees of the Seminar Series will have the opportunity to sign up for a case consultation group where they will receive direct clinical supervision from Professor Garrett (see below).

Dates: Tuesday 22nd July, 5th Aug, 19th Aug, 2nd Sept

Time: 10am-12pm (Australian Eastern Standard Time)

(recordings available on request for 7 days post-event for those unable to attend online)

Michael Garrett, MD is currently Professor Emeritus of Clinical Psychiatry at SUNY Downstate Medical Center in Brooklyn, New York. He is also on the faculty of the Psychoanalytic Association of New York (PANY) affiliated with NYU Medical Center in New York City. He currently teaches and supervises clinicians doing psychotherapy for psychosis and is a consultant to several first-episode for psychosis teams in the United States and elsewhere. He has a particular interest in the integration of cognitive behavioral and psychodynamic treatment in the psychotherapy of psychosis, as detailed in a Chapter in Kaplan & Sadock’s Comprehensive Textbook of Psychiatry 11th Ed (2024) titled Individual Psychodynamic Psychotherapy and Cognitive Behavioral Therapy for Psychosis and in his recent book, Garrett, M. (2019) Psychotherapy for Psychosis: Integrating Cognitive Behavioral and Psychodynamic Treatments. Guilford Press/New York.

Session 1: The biological and psychological genesis of psychosis

An outline of the history of psychotherapy for psychosis
Delusions are literally false but figuratively/metaphorically true
Clinical Example: The woman who feared her cat planned to murder her
Biology versus psychology in the etiology of psychosis
Genes versus life experience
Trauma and psychosis
Pathogenesis of psychosis: prodrome and phenomenology
Three-streams of experience that merge in psychotic symptoms. Alterations of perception of the external world, altered perception of the self, and delusional narrative
Dopaminergic hyper-salience and ideas of reference
1-factor and 2-factor cognitive models of delusion formation
Delusions as an autobiographical play staged in the real world that expresses the person’s life history and current state of mind
The mind as a self-organizing system
The man who feared a dog could look through his clothing and shame him
Altered self-experience: diminished ipseity and hyper-reflexive self-awareness
Primary and secondary process thinking – affect and symbolic thinking versus logical modes of thought
Integrating CBTp and psychodynamic treatment

Session 2: The developmental psychology of psychosis

Psychoanalytic developmental psychology as it pertains to psychosis
Psychoanalytic object relations theory (persecutory objects and voices)
The relationship between psychosis and ordinary mental life
Daydreams, fairy tales, and delusions
The use of metaphor and symbols in psychosis
Introduction to CBT for psychosis techniques (CBTp)
Complementary CBTp and psychodynamic formulations
Three models underlying CBTp: stress/vulnerability, continuum between psychosis and ordinary mental life; A-B-C cognitive sequence where A is an “activating event,” B is a belief about the meaning of A to the patient, and C is an emotional or behavioral consequence of that belief.
Engaging the patient
Empathic reflection of the patient’s account of their experience
Exploring the patient’s current coping mechanisms
Initiating treatment
Introducing the A-B-C model

Session 3: CBTp techniques (continued)

Agreeing to disagree about alternate explanations
Avoid a vote “Let’s see how our exploration turns out.”
Peripheral questioning “Let’s go into the details of what actually happened.” Drilling down on the A.
Rating the likelihood of beliefs
Rating the value of particular evidence
Informational handouts – increasing real world knowledge
Inference chaining “If that turned out to be true, what would that mean to you?”
Reality testing experiments - must be carefully designed
Homework assignments, e.g. voice hearing diaries
Challenge the power relationship with the voices
Exercises to build self-esteem
Two column analysis of beliefs.
“Catch it. Check it. Change it.”
Re-formulating the patient’s experience
Stress/vulnerability formulation
Cognitive bias formulation
Bio-psycho-social psychodynamic formulation
Passages from the book “I Never Promised You a Rose Garden”
CLINICAL EXAMPLE: The man who spent 15 years in a forensic hospital after having murdered his parents.
CLINICAL EXAMPLE: The woman who heard voices telling her that someone was about to die.
CLINICAL EXAMPLE: The woman who thought she was responsible for her mother’s almost dying, who was being pursued by the administration of the university she attended

Session 4: CASE PRESENTATIONS by Dr. Garrett

(previously presented in PsychAscend Tour - February 2025)

The case of Jane, who suffered a 20-year delusion that she had a horrible smell that people found unbearably offensive, that people in her neighborhood could read her mind and were talking to her through the walls of her apartment.
The case of James, who for 8 years feared each day when he went to work that he might be arrested. He believed that his co-workers were talking about him and heard threatening and demeaning whispers through the wall of his apartment.

General Enrollment Fee: $400 plus GST for attendance at webinar series (4 sessions)

Small Group Case Consultation: After completing these four seminar sessions, interested clinicians will have the opportunity to join a small case consultation group composed of 4-6 clinicians where they will present one of their patients to Dr. Garrett and the group. There will be a separate fee and registration process for these case consultation pods. In these consultations, each lasting 1 hour, clinicians will present their work with a patient and pose questions to be addressed by the group. A summary and transcript of the patient to be discussed will be distributed ahead of time so as to not spend time presenting material that attendees can read before the group meets, thereby leaving more time for discussion. In each session, Dr. Garrett will first offer a brief initial commentary on the patient and the treatment, then lead a discussion as the group works through the summary of the presenting clinician.