Compassionate, evidence-based support for individuals and families
Psychosis and schizophrenia can affect how a person thinks, interprets experiences, communicates, and manages daily life. A person may hear voices or see things that others do not. They may hold beliefs that feel convincing to them but are not shared by the people around them.
These experiences can feel immediate, confusing, or frightening. Family members may also feel worried and uncertain about how to help without increasing conflict or distress.
Dr. Irwin Rosenfarb provides psychosis and schizophrenia treatment in San Diego and aross California for adults and their families. His approach combines compassion, Cognitive Behavioral Therapy, practical support, and family education. With appropriate treatment and ongoing support, many people experiencing psychosis or schizophrenia can pursue meaningful relationships, greater independence, and active roles in their communities.
Understanding Psychosis and Schizophrenia
Psychosis refers to symptoms that affect how a person perceives or interprets reality. It can occur with schizophrenia, but it may also be associated with other mental health conditions, substance use, medical concerns, or severe sleep disruption.
Experiences associated with psychosis may include:
- Hearing voices or sounds that others do not hear
- Seeing people, objects, or images that others do not see
- Feeling that other people can read or control one’s thoughts
- Believing that others intend to cause harm
- Having difficulty organizing thoughts or communication
- Finding it difficult to determine whether certain perceptions are shared by others
Schizophrenia may involve psychosis as well as changes in motivation, emotional expression, thinking, concentration, and everyday functioning. Symptoms and support needs can vary considerably. Some people live independently with treatment, while others need more assistance managing routines, relationships, work, or basic needs.
If symptoms are new, changing quickly, or occurring for the first time, a timely psychiatric and medical evaluation is important. Psychotherapy should not be used to determine the cause of psychosis without an appropriate assessment.
How Symptoms Can Affect Daily Life
Psychosis and schizophrenia may make it harder to organize tasks, maintain routines, communicate, participate in work or school, or connect with other people. Distressing experiences can also lead someone to withdraw or avoid situations that no longer feel safe.
Stress does not necessarily cause schizophrenia, but significant stress can intensify symptoms or make daily functioning more difficult. Genetics, brain development, biology, environment, and other factors may also contribute. Neither the person nor the family is to blame for the condition.
Treatment can help identify the areas creating the most difficulty and develop practical strategies based on the person’s needs, abilities, and goals.
CBT for Psychosis
Dr. Rosenfarb uses Cognitive Behavioral Therapy to help clients explore connections among thoughts, perceptions, emotions, and behavior.
CBT for psychosis does not require arguing with someone about whether an experience is real. Therapy can instead explore what the experience means to the person, how it affects emotions and behavior, and whether different responses could reduce distress.
For example, someone who feels monitored by others may become anxious and avoid leaving home. Therapy can help the person examine the situations that increase this fear, understand the resulting emotions, and develop ways to feel safer and remain engaged in daily activities.
Depending on the person’s needs, therapy may help with:
- Coping with voices or unusual perceptions
- Responding to distressing beliefs
- Managing anxiety and stress
- Strengthening problem-solving skills
- Creating supportive routines
- Improving communication and relationships
- Working toward greater independence
- Participating more fully in work, school, or community life
Working With Families
Psychosis and schizophrenia can also affect partners, parents, siblings, and other relatives. Family members may not understand what their loved one is experiencing or may be unsure when to listen, encourage treatment, set boundaries, or seek additional help.
Dr. Rosenfarb works with families to increase understanding, reduce blame, and develop more effective communication. Family members can learn how symptoms may influence behavior and daily functioning while identifying ways to offer support without taking away the person’s dignity or independence.
If a loved one does not share the family’s concerns or is not ready to seek treatment, family sessions may still provide useful education and guidance.
Therapy as Part of Comprehensive Treatment
Psychotherapy is often one part of schizophrenia treatment in San Diego and across California. Depending on the situation, care may also involve psychiatric evaluation, medication, medical monitoring, case management, community services, or supported education and employment.
Dr. Rosenfarb can coordinate with psychiatrists and other professionals when appropriate. Medication decisions should always be discussed with the prescribing clinician.
People experiencing a first episode of psychosis may benefit from a coordinated specialty care program that brings together medical, therapeutic, family, educational, and employment support. An introductory conversation can help determine whether outpatient psychotherapy with Dr. Rosenfarb is appropriate or whether another level of care may better match the person’s current needs.
An Experienced Psychologist for Psychosis and Schizophrenia
Dr. Rosenfarb is a licensed psychologist with more than 40 years of experience. He is also the former Director of the Clinical Psychology PhD program at Alliant University, San Diego, and is currently Professor Emeritus in the Clinical Psychology Ph.D. program at CSPP/Alliant University. He has served as principal investigator on an NIMH research grant and has authored more than 100 publications and presentations.
His treatment is collaborative and adapted to each person’s symptoms, functioning, relationships, strengths, and goals. He also helps families better understand serious mental health conditions and develop practical ways to provide support.
Therapy in Scripps Ranch, Sorrento Valley, and across California
Dr. Rosenfarb provides psychosis therapy in San Diego at offices in Scripps Ranch and Sorrento Valley. He also provides psychosis therapy online throughout California.
If someone may be in immediate danger, cannot care for basic needs, or requires urgent psychiatric attention, call 911 or go to the nearest emergency room. If you or someone you know is experiencing emotional distress or thoughts of suicide, call or text 988. This practice does not provide emergency or crisis services.
Contact Dr. Rosenfarb to schedule an introductory phone conversation and discuss whether therapy may be appropriate for you or your family member.