This review outlines the role that cognitive behavioral therapy can play in specifically addressing the distress associated with the symptoms of schizophrenia, such as hallucinations and delusions. Some of the features that are given greater emphasis (or are a feature of working with people with psychotic illness), engagement, understanding the onset of the illness and work with hallucinations and delusional beliefs are outlined. The evidence base for the utility of cognitive behavioral therapy is considered, and the development and further application of cognitive behavioral therapy for schizophrenia and related disorders are outlined.