Supporting someone with psychosis
A guide for family and friends about listening, shared early signs, your own support and routes to help during psychosis.
Written by Tarun Vermani, Trainee Clinical Psychologist Last reviewed
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Supporting someone with psychosis
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What the person may be experiencing
Use this guide with the person's consent and agree what may be shared. Psychosis can involve hearing or seeing things others do not, beliefs that others find hard to share, or thoughts that feel confused. Experiences vary and may feel frightening or very real to the person. Ask how they describe it instead of assuming you know. Psychosis does not define the whole person; recovery can mean different things to each person.
Stay calm and listen
Use short, clear sentences and allow time to reply. Acknowledge the feeling without arguing about or agreeing with an unusual belief. You might say, "That sounds frightening. I understand it differently, but I want to hear what would help." Avoid trying to prove the person wrong or confirming the belief to settle an argument. Ask whether they would prefer company, space or help contacting their team.
Use signs and plans the person has shared
With their consent, discuss early changes they have noticed before, such as sleep disruption or withdrawing, and the support they want. Agree what may be shared with the team. These signs are individual, not proof of relapse. Avoid secret monitoring or checking every change. The team leads clinical assessment; you are not responsible for assessing or managing risk.
Your needs matter too
Caring can be tiring and bring mixed feelings. Keep time for rest, your own relationships and support. Ask the team about carer information, family work and local carer services. In the UK, you can ask your local council or relevant social care service about a carer's assessment of your own support needs. Names and arrangements vary across the UK. You can tell the team about your concerns and ask for support for yourself, even if the person has not agreed to your involvement. The team may be limited in what personal information it can share with you. Ask it to explain confidentiality, including when safety concerns may require information to be shared.
When support cannot wait
If the person is deteriorating or you are worried about safety, contact their team through the agreed route. If urgent help is needed and the team is unavailable, use the agreed urgent-care contact. If anyone is in danger, call 999. Do not wait for the next appointment or for this sheet to be read. You can raise urgent safety concerns even when consent to share information has not been given; the service will explain what it can tell you.
Support you could discuss
Choose only what fits the person's wishes and your capacity.
Keep your routes to help accessible
With consent, agree the details together. Keep personal names and private information off this sheet.
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When to use ‘Supporting someone with psychosis’
‘Supporting someone with psychosis’ is a psychoeducation handout based on cognitive behavioural therapy (CBT), most often used in CBT for psychosis.
It is designed to be read by a family member or supporter, ideally together with the person and their therapist. You can preview the full handout above, then use it on any device or download it as a print-ready PDF. The therapist can help everyone agree how to use it within the person's therapy.
How it works
Most people work through it in around 12 minutes. It moves through six short sections to read:
- What the person may be experiencing: Use this guide with the person's consent and agree what may be shared. Psychosis can involve hearing or seeing things others do not,…
- Stay calm and listen: Use short, clear sentences and allow time to reply. Acknowledge the feeling without arguing about or agreeing with an unusual belief. You…
- Use signs and plans the person has shared: With their consent, discuss early changes they have noticed before, such as sleep disruption or withdrawing, and the support they want.…
- Your needs matter too: Caring can be tiring and bring mixed feelings. Keep time for rest, your own relationships and support. Ask the team about carer…
- When support cannot wait: If the person is deteriorating or you are worried about safety, contact their team through the agreed route. If urgent help is needed and…
- Support you could discuss: Choose only what fits the person's wishes and your capacity.
The handout can be read on a phone, tablet or computer, or downloaded as a print-ready PDF. A family member or supporter can discuss their responses with the person and their therapist.
The CBT approach behind it
‘Supporting someone with psychosis’ introduces a CBT approach that involves noticing the links between situations, thoughts, feelings, physical sensations and behaviour and finding practical ways to change unhelpful patterns. The aim is not positive thinking but a clearer, shared understanding of what keeps a difficulty going and practical, testable ways to change it.
Because it is a CBT tool it stays focused on the here-and-now links between thoughts, feelings, the body and behaviour, and it works best as one part of a wider course of therapy rather than as advice or a diagnosis.
Evidence & sources
This handout is grounded in established cognitive behavioural therapy theory and practice. Key sources include:
- National Institute for Health and Care Excellence (2014). Psychosis and schizophrenia in adults: prevention and management. NICE guideline CG178.
- National Institute for Health and Care Excellence (2020). Supporting adult carers. NICE guideline NG150.
For use alongside professional support
Formulate provides educational CBT resources for use with a qualified therapist. They are not a substitute for professional assessment, diagnosis, or crisis care.
If you need urgent help now:
- Emergency services: 999 — if you or someone else is in immediate danger
- NHS 111 (NHS 24 in Scotland): 111 — choose the mental health option for urgent help, in England, Scotland and Wales (in Wales, press 2)
- Lifeline: 0808 808 8000 — for urgent help in Northern Ireland, free, day or night
- Samaritans: 116 123 — free, day or night, 365 days a year
- Shout: 85258 — text SHOUT, free, day or night
- SANEline: 0300 304 7000 — 4pm–10pm, every day
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