CBTp Flashcards
why was cbtp introduced
because drug therapy only REDUCES symptoms so it was introduced to deal with the symptoms left over from drug therapy (persistent + and -) and improve their level of functioning
the 2 are used in conjunction for management of sz and long term recovery
what does cbtp stand for and what is it
cognitive behavioural therapy for psychosis
it is regular cbt adapted for psychosis eg sz
how many sessions of cbtp does nice recommend
minimum 16 (1 to 1 sessions)
what is the basic assumption of cbt
people have distorted beliefs and faulty interpretations (> delusions) and these influence their feelings and behaviours
in cbt what needs to happen to the distorted beliefs and faulty interpretations that influence their feelings and behaviours
links need to be established between thoughts feelings and behaviour AND their symptoms and level of functioning
SO that the szi can understand why they feel and behave like they do
hopefully reduce distress and improve level of functioning»_space; everything is less frightening and so anxiety is reduced and symptoms are reduced
how does cbtp help szi cope with the symptoms of sz (overall statement)
they can be helped to make sense of how their delusions and hallucinations impact their feelings and behaviour
how does cbtp help szi cope with the symptoms of sz (what are the 2 methods)
alternative explanations
normalisation
what are the alternative explanations for sz offered in cbtp
exp eg for sz
alt exps help the szi understand where their symptoms come from > helpful
psych exps for existence of hallucinations and delusions > reduce anxiety
EG if therapist persuades szi that the “demonic voices triggering high anxiety” are actually from the malfunctioning speech centre in their brain and it cannot hurt them then this is less frightening and disabling
although this doesnt eliminate the symptoms it may make the szi more able to cope with the symptoms and reduce their distress and improve their ability to function on a daily basis
what is normalisation
if szi are taught that the voice hearing is an extension of the ordinary experience of thinking in words then this is normalisation
placing psychotic experiences on a continuum with normal experiences then szi feels less alienated and so increases possibility of recovery
what happens in the assessment phase of cbtp
patient expresses their thoughts about their experiences to therapist and they discuss realistic goals using the current distress as motivation
what happens in the engagement phase of cbtp
therapist empathises with patients perspective and feelings of distress
and an explanation for the distress can be developed together
support for effectiveness of cbtp: NICE’s review of treatments for sz found…
consistent evidence (reliable) that when compared to standard care (APs alone) cbtp WAS effective in reducing rehospitalisation rate up to 18mths following the end of treatment
also effective in reducing symptom severity
also effective for improvement in social functioning compared to receiving standard care
so good for managing symptoms
what is Jauhar find the in their review of ….
34 studies using cbtp with szis
was evidence to support small but significant effects on both pos and neg symp
ie small but big impact, psychological significance, difference in how much symptoms reduced between groups
a limitation of meta analysis studies for effectiveness of cbtp is that they fail to consider …
the quality of the studies
eg many fail to randomly allocate individuals into cbtp and control groups (unlike drug treatments, cant really do it as you would know if youre having cbtp and ethically they would have to consent to cbtp so they would know what theyre getting)
interviewers doing follow up assessments not always blind to which condition the individual was allocated to
