To Treat or Not to Treat: Responding to Psychotic Experiences

Psychotic experiences (PE) have been found to be much more common in the general population than psychotic disorders, yet research is currently ambivalent about whether or not PE warrant clinical treatment, and what treatment should entail. In light of this dilemma, we review the definitions of PE and how they differ from two related sub-threshold phenomena, which are 'clinical high risk' and 'voice hearing'. Then we discuss the clinical significance of PE with respect to three areas: (i) the risk of transitioning from PE to threshold psychotic disorder, (ii) the distress and impairment associated with PE irrespective of transition and (iii) the treatment-seeking behaviours and need for care of people with PE. Finally, we consider the implications for social work practice and underscore the importance of a person-centred treatment system to detect and respond to PE while working with social support systems.