In this chapter we discuss fears of harm from others, also known as ‘paranoia’. We foreground the experiences of people who have lived experience and ask them to describe this in their own words. We consider defining features, disputed terminology, and theoretical perspectives. We relate how cognitive models conceptualise paranoia, including the proposition that it occurs on a continuum from everyday worries in the general population to more distressing and disruptive fears. We discuss contested ideas about ‘delusions’ as fixed beliefs and the role of appraisals, and offer a view, which emphasises dynamic processes of sense making and multidimensionality. We then turn to ways of engaging people and assessing some key aspects of thinking styles, ‘belief flexibility’. Recent research innovations are discussed, ‘causal interventionist’ research targeting mechanisms to improve treatment effectiveness, and digital innovations in treatment, such as virtual reality, mobile apps, and new blended treatments. Finally, we introduce SlowMo, a novel blended digital therapy for fears of harm from others.

Original languageEnglish
Title of host publicationA Clinical Introduction to Psychosis
Subtitle of host publicationFoundations for Clinical Psychologists and Neuropsychologists
Number of pages23
ISBN (Electronic)9780128150122
Publication statusPublished - 1 Jan 2019


  • Delusions
  • Digital
  • Fast and slow thinking
  • Fear of harm
  • Paranoia
  • SlowMo


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