Bradshaw Case Study Flashcards
What is the aim?
- To investigate how CBT can be used to treat a woman with sz.
- To illustrate how CBT can be adapted to the unique needs of people with schizophrenia as distinct from other clinical disorders in order to create a “disorder-relevant” version of CBT.
What was the sample?
One adult female called carol who was 26 years old at the start. She suffered from sz.
What was the procedure?
Clinical outcomes including psycho-social functioning, severity of symptoms, attainment of treatment goals and hospitalisations were assessed periodically over the three years of treatment and the patient was followed up one year later; the CBT sessions lasted anything from 15 minutes to an hour or more dependent on the client’s current condition. The therapist and client would go for walks during the sessions when Carol was agitated or lethargic. There were 4 phases to the treatment; socialisation, the early phase, the middle phase and the ending phase each of which need careful summarising.
How was carols symptoms measure when receiving CBT?
They were measure on 4 scales:
- Role functioning scale (rfs).
- The goal attainment scale (gas).
- Hospitalisation (how often admitted).
- Global pathology index (gpi).
What does the role functioning scale measure?
A checklist which gives a score for work, social life, family relationships and independent living then totals them all together.
What does the global attainment scale measure?
It measures how many of the goals carol agreed with her therapist she was meeting. They might be things like cutting down on medication, getting a job etc.
What does hospitalisation measure?
The number of times carol was admitted back to hospital.
What does the global pathology index measure?
It’s and 8 point scale ranking how sever the symptoms of sz are.
What did carols baseline score of 7 indicate on the gpi?
Indicated sever problems such as: inappropriate mood, hallucinations and delusions, impaired judgement, disorganised thinking and inability to care for herself.
What was the 1st stage of carols treatment?
CBT sessions last from 15mins to 1hr and carol and her therapist often went for a walk together. To help build rapport the therapist disclosed his own problems to interest carol and get her to talk about hers.
What was the 2nd stage of her treatment?
Help her understand CBT and decide on treatment goals took about 2 months. It involves educating her about sz and how it might be treated. The ABC model (Ellis 1957) was used.
How does the ABC model help Carol?
It used to help understand an activating event (A) that triggers stress and it’s emotional consequences (C). Carol reflected on her thinking or behaviour (B) that could have led to those emotional consequences.
What were the results?
Results indicated considerable improvement in psychosocial functioning, achievement of goals, reduction of symptomatology and number of hospitalisations and maintenance of treatment gains at the 6 month and 12 month follow-ups. There are a variety of quantitative findings which can be easily learnt.
What was the conclusion?
CBT is a potentially useful intervention in the treatment of schizophrenia and to help with stress management in order to prevent relapse and facilitate the recovery process. It has shown that CBT is not just useful in brief treatment of delusions and hallucinations but can help with the multiple problems experienced by clients in recovery. The study was helpful in identifying schemas which mediated the clients ability to cope with the impact of schizophrenia which can then be worked on in treatment and demonstrates that further qualitative work needs to be done to reveal whether these schema are similar in other clients with schizophrenia.
