CBTp Treatment of Schizophrenia Flashcards
why is Normal CBT is inappropriate for psychotic disorders
because SZ is largely biological and cannot yet be “cured”.
how does CBTp aim to help patients
CBTp aims to help patients to identify irrational thoughts and challenge them (including the origin of ‘voices’) and reality testing them to reduce distress.
It usually takes place for 5-20 sessions, with NICE recommending at least 16 sessions.
what model does cbtp use
CBTp uses the ABCDE model.These beliefs can then be rationalised, disputed (D) and changed through critical collaborative analysis, leading to the effect (E) of restructured beliefs.
Critical collaborative analysis –
the therapist uses gentle questioning to help the patient to understand and challenge illogical deductions and conclusions e.g. ‘if your voices are real, why can no one else hear them?’
how is cbtp beneficial for helping patients cope with their disorder
Rather than ‘getting rid’ of schizophrenia, CBTp helps patients to cope better with their symptoms because it reduces distress.
normalisation
The therapist shares with the patient that many people have unusual experiences such as hallucinations and delusions in many different circumstances. This reduces anxiety and the sense of isolation by making the patient feel less alienated and stigmatised. This makes the possibility of recovery seem more likely.
evaluation 1: weakness of using cbtp
a problem for CBTp is that it doesn’t cure schizophrenia
evaluation 2: weakness of using cbtp
E - the aim is to normalise and cope with symptoms. Some argue this is a poor investment for NHS as cbtp is an expensive process.
evaluation 3: weakness of using cbtp
E - however, NICE showed cbtp is more effective than antipsychotic drugs for symptoms and reduces relapse by half. This is especially helpful given serious side effects from drugs
evaluation 4: weakness of using cbtp
therefore cbtp seems to be ecologically valid despite economic drawbacks vs drugs. This highlights the reason for an interactionist treatment approach and good cost-benefit analysis.
evaluation 2- comparison with ACT
a weakness of CBTp is that it’s not effective for all patients
research shows that 25% of patients don’t respond to CBTp and ⅓ don’t respond to drug treatment
evaluation 2- comparison with ACT (2)
E - however, ACT gives a successful alternative for those who are treatment-resistant focusing on humanist (commitment to values) and psychodynamic (acceptance of struggles) principles
ACT facilitates a shift from focusing on trying to control internal events to focusing more on behavior-change processes that can lead to positive outcomes. the approach is to reduce the client’s tendency to try to make literal sense of
an experience when it is not useful
evaluation 2 comparison with ACT (3)
while CBTp is more effective than drug treatment it does not generalise to all patients reducing its ecological validity as therapy is expensive and a large proportion of patients do not benefit- harmful for the economy. This may partly be explained by the machine reductionism of cognitive therapies; a more holistic approach like ACT can help a wider range of patients.
