CBT: CSE Flashcards
What the Therapy Does?
Therapy teaches schizos new coping strategies that builds on existing ones.
Aim is to systematically teach the individual how to use effective coping strategies to reduce the frequency, intensity and duration of the psychotic symptoms and accompanying distress.
CSE involves education and rapport training: therapist helps client improve effectiveness of original strategies as well as developing new ones.
Also teaches symptom targeting where a symptom will be selected preferably one already with a coping strategy.
These are enhanced and new ones are introduced.
Clients must practice them for homework.
Crucial that at least two strategies for each symptom is adopted based on the finding that the presence of more coping options reduces stress.
Tarrier 1987
Held detailed interviews with schizos and found that one third of his sample could often identify triggers to the onset of their psychotic symptoms: social situations and emotional states.
Also developed individual methods for coping with distress caused by hallucinations and delusions.
Coping strategies included things such as: distraction, attention narrowing and positive self talk.
A third of patients used behavioural strategies such as initiating social contact and a quarter withdrew into solitary activities.
Other strategies include drowning the voices out by turning up the tv or using relaxation methods.
At least 70% reported having at least one strategy that is moderately successful.
Using multiple coping strategies was associated with increased ability to cope.
Tarrier et al 1993
Researched 49 people.
Found significant alleviation of positive symptoms in a CSE group as opposed to a non treatment group.
50% of patients demonstrated a significant decrease in hallucinations and/or delusions.
Significant improvement in the effective use of coping skills compared to the control group.
Improvements were still apparent after 6 months.
Difference was marginal.
45% of 49 patients refused to participate or dropped out.
Therapy would be good for SOME schizos.
Pfammatter et al 2006
Did a meta analysis and found CSE can be very effective for severe positive symptoms in terms if easing distress and decreasing symptoms.
Some of the gains are probably due to the neuroleptics.
