CBT Flashcards
INTRO - people have _ beliefs which influence their feelings and behaviours in _ ways
people have distorted beliefs which influence their feelings and behaviours in maladaptive ways
what do delusions result from and what does CBTp do to help
delusions result from faulty interpretations of events, CBTp helps to identify and correct these faulty interpretations
who is it done with
groups or individuals
what does it help p’s establish
links between thoughts, feelings, actions and symptoms and level of functioning
what does it help p’s consider
alternative explanations of why they feel/behave how they do
what does NICE recommend
at least 16 sessions for Sz
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
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
what can therapists set and why
behavioural homework to improve level of functioning
therapist lets the patient develop their own _ and _ strategies
therapist lets the patient develop their own alternatives and coping strategies
what is assessment
patient expresses thoughts about experience, goals are discussed, distress used as motivation
what is engagement
therapist empathises and says there is an explanation
what is the ABC model
what is the activity agent (cause), what behaviour/beliefs has this created and what is the consequence
what is normalisation
the therapist informs the patient that many people have unusual experiences, reduces the sense of isolation
what is critical collaborative analysis
gentle questioning to help patient understand illogical conclusions “if they are real, why can’t I see them?”
what is alternative explanations
new ideas from the patient prompted by the therapist
E- advantages of CBTp over standard care - what did NICE review find? what is the problem with this?
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
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
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
E- ethical issues - lack of CBTp availability, how many UK Sz p’s are offered it? what did Haddock find?
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
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?
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
E- methodological issues, who found that the more rigorous the study the less effective CBTp was
Wykes
E- benefits may be overstated. who? found there is only a small effect on key symptoms. and what happened when assessed blind?
Jauhar et al found there is only a small effect on key symptoms and effects disappeared when assessed blind
E- problem with benefits being overstated leads to confections in recommendations, what do NICE and SIGN recommend?
NICE - emphasise non-drug therapy
SIGN - more emphasis on drug therapy
