CBT - schizophrenia Flashcards
the aims of CBT?
- teach link between perceptions and beliefs
- question apparent evidence of abnormal beliefs
- encourage sled monitoring beliefs
- teach effective coping strategies
purpose of CBT?
to help an individual organise their disorganised throughs in a rational manner making them more aware of their thoughts
what symptoms does CHT help relieve?
positive symptoms such as hallucinations and delusions
how many sessions are required?
8 - 20 sessions over a space of 6 - 12 months, sessions usually last for an hour
key components of CBT?
- engagement strategies
- psycho-education
- behavioural skills training
- relapse prevention strategies
engagement strategies?
therapist and client develops a connection which is important in order to help try alleviate their symptoms as trust is needed during this process. they may also discuss any natural coping strategies the client currently uses to manage their symptoms
psycho education?
3 main functions.
- firstly normalises the experience of psychotic symptoms, offering alternative explanations of clients experience of their symptoms
- secondly, client increases their own understanding of why their symptoms occur
- lastly, therapist assesses the clients understanding of their symptoms and illness
behavioural skills training?
behavioural strategies are taught such as relaxation and problem solving. this is helpful with not only copingkith residue symptoms not managed by medication but any possible secondary symptoms such as anxiety. Problem solving helps the client work systematically to identify the problem, generate possible solutions and evaluate alternatives
relapse prevention strategies?
therapist and client identify early warning indicators of relapse. identifying thoughts, behaviours and feelings they experience before becoming unwell. they then develop plans that could be employed when these indicators are observed. this helps to indicate what things they can do to help themselves.
3 effectiveness points?
- effective form of treatment
- contradictory evidence
- short term evidence
effective form of treatment?
kuipers - studied 60 individuals with SZ that were medication resistant. they were randomly allocated to their CHT or standard care. after 9 months 50% of patients in CBT condition were considered improved, in standard care 31% were considered improved proving CBT is significantly more effective
contradictory evidence?
Jaguar - reported only a small therapeutic effect from using CBT with clients with SZ however Morrison reported CBT significantly reduced psychiatric symptoms of SZ this lack of consistent findings suggests its ineffective.
short term effectiveness?
the effectiveness of CBT has only come from short term programmes. research has investigated longer term effectiveness of CBT and found it to be less positive. Tarrier studied those who have received wither CBT or standard care 18 months later the CBT group had the same relapse rates as those with standard care suggesting it provides some short term effectiveness however is not effective in the long term
2 ethical implications?
- potentially negative experience for clients
- some psychiatric may limit access to CBT
potentially negative experience for clients?
suffering symptoms of SZ, being assessed and diagnosed, then being prescribed strong medication are all quite daunting experiences. Kuiper’s reported clients were generally satisfied with their experience of CBT therefore it is important in reviewing CBT from a clients perspectives especially in its ethical impact
some psychiatrists may limit access to CBT?
some working in psychiatric services may not feel CBT is an option for many suffering from SZ. this decision may be made based on the fact they may not believe their diagnosis of SZ is accurate. in fact research reported that of 142 individuals diagnosed with SZ only 49% had been referred for CBT. psychiatric prejudice may be limited access to CBT in individuals that could benefit from it
2 social implications?
- is CBT being offered to everyone
- CBT is cost effective
is CBT being offered to everyone?
theres a significant variation in the amount of people with SZ who are being offered CBT within different geographical locations. its claimed the variation between 67% to only 14% of SZ being offered CBT with an average of 50% of people reporting their trust had not offered them CBT
CBT is cost effective?
Kuipers analysed the economic impact of offering CBT to individuals with SZ. The costs of CBT are initially more expensive however in long term those costs are likely to be recouped due to SZ being less likely to need emergency psychiatric services this is a benefit since money is saved for other health treatments.
