CBT

Question 1

INTRO - people have _ beliefs which influence their feelings and behaviours in _ ways

Answer 1

people have distorted beliefs which influence their feelings and behaviours in maladaptive ways

Question 2

what do delusions result from and what does CBTp do to help

Answer 2

delusions result from faulty interpretations of events, CBTp helps to identify and correct these faulty interpretations

Question 3

who is it done with

Answer 3

groups or individuals

Question 4

what does it help p’s establish

Answer 4

links between thoughts, feelings, actions and symptoms and level of functioning

Question 5

what does it help p’s consider

Answer 5

alternative explanations of why they feel/behave how they do

Question 6

what does NICE recommend

Answer 6

at least 16 sessions for Sz

Question 7

participants are encouraged to trace back the _ of symptoms to get an idea of how they _. encouraged to evaluate the _ of their delusions/voices and consider ways to test _ of them

Answer 7

participants are encouraged to trace back the origins of symptoms to get an idea of how they developed. encouraged to evaluate the content of their delusions/voices and consider ways to test validity of them

Question 8

what can therapists set and why

Answer 8

behavioural homework to improve level of functioning

Question 9

therapist lets the patient develop their own _ and _ strategies

Answer 9

therapist lets the patient develop their own alternatives and coping strategies

Question 10

what is assessment

Answer 10

patient expresses thoughts about experience, goals are discussed, distress used as motivation

Question 11

what is engagement

Answer 11

therapist empathises and says there is an explanation

Question 12

what is the ABC model

Answer 12

what is the activity agent (cause), what behaviour/beliefs has this created and what is the consequence

Question 13

what is normalisation

Answer 13

the therapist informs the patient that many people have unusual experiences, reduces the sense of isolation

Question 14

what is critical collaborative analysis

Answer 14

gentle questioning to help patient understand illogical conclusions “if they are real, why can’t I see them?”

Question 15

what is alternative explanations

Answer 15

new ideas from the patient prompted by the therapist

Question 16

E- advantages of CBTp over standard care - what did NICE review find? what is the problem with this?

Answer 16

CBTp was more effective in reducing re-hospitalisation rates up to 18 months after therapy, and reducing symptom severity and improve social functioning. problem is most studies involve p’s treated by anti-psychs and CBTp so it is difficult to assess effectiveness

Question 17

E- effectiveness is dependent on stage of disorder, may be more effective at specific stages and when delivery of treatment is adjusted according to their stage. who? found what about the stage and type of CBTp that is most effective

Answer 17

Addington and Addington found in the initial stages of Sz group therapy is more effective to help normalise their disorder. more experienced patients should have individual sessions as they have a greater realisation of their problems so don’t need to learn from others

Question 18

E- ethical issues - lack of CBTp availability, how many UK Sz p’s are offered it? what did Haddock find?

Answer 18

only 1/10 schizophrenics in the UK are offered it, may be none in some areas. Haddock found 13/187 p’s in North West England had been offered it. of those some refused or didn’t show to appointments

Question 19

E- methodological issues, give an example of why meta-analysis can lead to unreliable conclusions due to study quality. what did Juni et al find?

Answer 19

e.g. fail to randomly allocate p’s into CBTp or control condition. found clear evidence that problems with methodologically weak trials created bias finding of effectiveness

Question 20

E- methodological issues, who found that the more rigorous the study the less effective CBTp was

Answer 20

Wykes

Question 21

E- benefits may be overstated. who? found there is only a small effect on key symptoms. and what happened when assessed blind?

Answer 21

Jauhar et al found there is only a small effect on key symptoms and effects disappeared when assessed blind

Question 22

E- problem with benefits being overstated leads to confections in recommendations, what do NICE and SIGN recommend?

Answer 22

NICE - emphasise non-drug therapy

SIGN - more emphasis on drug therapy