Clinical psychology

Question 1

What are the 5 HCPC guidelines

Answer 1

Act in best interest of patient
Able to maintain records appropriately
Being able to practice and follow ethical guidelines of practice
Being able to ensure quality of practice
Being able to work and communicate effectively with others

Question 2

3 examples of act in best interest of patient

Answer 2

Not do anything that may put patients in harm or danger in anyway
If patient perceived to be a risk to themselves break confidentiality to ensure they get help they need
Not allow sex/religion to influence how they are treated

Question 3

3 examples of able to maintain records appropriately

Answer 3

Ensure all records are kept safe and confidential by limiting access using passwords
Ensure peoples records are kept separately to others
Show patients notes so they can say if they agree

Question 4

3 examples of Being able to practice and follow ethical guidelines of practice

Answer 4

Ensure confidentiality is not breached by storing records safely using pseudonyms
Don’t do anything to put your patient through harm
Potentially break confidentiality for safety of patients

Question 5

3 examples of Being able to ensure quality of practice

Answer 5

Undertake regular training each year to ensure they are up to date on all current knowledge of diagnosis and disorders
Only act within limits of own skill ask for second opinion when necessary
Follow ethical guidelines including confidentiality using pseudonym to protect identity of patient

Question 6

3 examples of Being able to work and communicate effectively with others

Answer 6

Build trust with patient to allow full communication
Communicate with other service providers like social workers
Act within own knowledge and ask for second opinion

Question 7

What are the 4 D’s

Answer 7

Used by clinicians to determine if someone’s behaviours are abnormal and need further diagnosis
Deviance
Distress
Dysfunction
Danger

Question 8

What is deviance in 4 D’s with example

Answer 8

Behaviours and emotions that are not seen as the norm in society and they are seen as unacceptable
E.g. Feeling like the mafia is after you is not normal in society

Question 9

What is distress in 4 D’s with example

Answer 9

Subjective experience of the individual when the behaviour is causing high levels of negative feelings
E.g. Person who is paranoid the mafia is coming for them would feel great negative emotions as they think they will get caught or hurt

Question 10

What is dysfunction in 4 D’s with example

Answer 10

Person is unable to partake in everyday activities due to significant interference of behaviour, however cant signal disorder on its own as it can be deliberate
E.g. Cant walk to school in fear of mafia kidnapping them

Question 11

What is danger in 4 D’s with example

Answer 11

Putting themselves and/or others lives at risk thus requires intervention
E.g. harming a stranger due to belief the mafia are coming.

Question 12

2 strengths of 4 D’s

Answer 12

Davis - Hard to judge when a behaviour is problematic enough to become a clinical diagnosis. 4 D’s can help by matching the DSM criteria. T/F has practical applications.
Validity of DSM -

Question 13

2 Weaknesses of the 4 D’s

Answer 13

Subjective application of 4 D’s - No clear measure, one professional may view dysfunction different to another, T/F reduces validity as requires subjective interpretation
Davis, 5th D - Duration, length of time someone has they symptoms, T/F 4 D’s are insufficient by themselves for diagnosis

Question 14

Summarise the DSM-IV-TR (4)

Answer 14

Multi axial system of classification on an individuals mental state
Rated on 5 separate dimensions axis I-V
Axes I - III deal with their present condition while 4-5 provide info about there life and how likely they are to be successful at coping in life
The GAF scale represents the 5th stage and examines the psych, social and occupational areas. Scored 0-100 with the higher the better functioning they are.

Question 15

3 changes from DSM-IV-TR to DSM 5

Answer 15

No longer a multi-axial system (no axis I, II or III)
GAF has been dropped
New classifications of some disorders. Some have disappeared or been absorbed into other disorders.

Question 16

4 changes to the ICD from 10 to 11

Answer 16

ICD 11 is more detailed and structured than 10. 55,000 codes vs 14000 in 10
French is now available as well as Chinese, Russian and Spanish
New mental behavioural and neurodevelopment conditions - gaming disorder, binge eating disorder
New specific diagnosis for sleep wake diagnosis including sleep related breathing disorders

Question 17

Summarise the ICD (4)

Answer 17

ICD-10 is multi-lingual and multi-disciplinary diagnostic manual looking and classifying mental health disorders and general health disorders.
The ICD contains section F, which is specific for mental health disorders. Within this section it groups each disorder as being part of a family, for example mood (affective) disorders.
These disorders are coded F followed by a digit to represent the family, (F32 is depression whereas F31 is bipolar disorder).
Further categorisation comes at the next digit that follows a decimal point were the type of depression is represented (for example, F32.0 is mild depression).

Question 18

What is inter rater reliability in terms of diagnosis

Answer 18

Present the same case study to a variety of clinicians and assess the extent of agreement. If there is agreement in diagnosis then there is inter-rater reliabilit

Question 19

What is test retest reliability in terms of diagnosis

Answer 19

Test them 2 or more times and see if they receive the same diagnosis. Cannot be done over a long period of time

Question 20

3 strengths of general reliability of DSM/ICD

Answer 20

Jakobsen - found good agreement in diagnosis of SZ between ICD 10 and other classification systems
Andrews - 1500 patients using DSM IV and compared to ICD and found agreement on diagnosis for depression and general anxiety
Morey - DSM 5 more reliable than DSM IV in diagnosing borderline personality disorder

Question 21

Weakness of general reliability of DSM/ICD

Answer 21

Andrews however - 68% agreement between ICD and DSM. For PTSD was poor as ICD diagnosed 2x as many. T/F wont produce consistent diagnosis so not reliable for PTSD

Question 22

Strength of inter-rater reliability of DSM/ICD

Answer 22

Goldstein - 199 patients with SZ re-diagnosed using DSM 3 when originally diagnosed on DSM 2. 2 experts re-diagnosed 8 patients using single-blind technique and found high level of agreement between them.

Question 23

Weakness of inter-rater reliability of DSM/ICD

Answer 23

Unstructured interviews - Gather info about patients through unstructured, clinical interviews meaning patients may provide different info to different practitioners. T/F Unreliable

Question 24

2 strengths of Test-retest reliability of DSM/ICD

Answer 24

Stinchfield- using patients recruited from treatment program in Ontario or local community diagnosed them using DSM 5 and accurately identified 91 as having or had gambling disorder

Question 25

2 weaknesses of Test-retest reliability of DSM/ICD

Answer 25

Subjective interpretration - Phrasing of criteria in DSM is open for interpretation. Some disorders such as hyper tension (high blood pressure) are on a continuum so not a yes or no.

Question 26

What is concurrent validity in terms of diagnosis

Answer 26

A diagnosis will be valid if you compare the diagnosis of one diagnostic manual with a manual that has already been found to be valid and if they match the diagnosis the manual will have concurrent validity

Question 27

2 strength of concurrent validity for ICD/DSM

Answer 27

Andrews - 1500 patients using DSM IV and compared to ICD and found agreement on diagnosis for depression and general anxiety
Lee - For diagnosis of ADHD there was agreement when using DSM IV and other measures such as questionnaire data

Question 28

Weakness of concurrent validity for ICD/DSM

Answer 28

Andrews however - 68% agreement between ICD and DSM. For PTSD was poor as ICD diagnosed 2x as many. T/F wont produce consistent diagnosis so not reliable for PTSD

Question 29

What is predictive validity in terms of diagnosis

Answer 29

If it predicts the course of illness accurately - prediction of future behaviour caused by the disorder it is predictively valid

Question 30

Strength of predictive validity for DSM/ICD

Answer 30

Powers et al - women who had suffered complex PTSD also had higher level of substance and alcohol abuse as predicted by ICD 11

Question 31

Weakness of predictive validity for DSM/ICD

Answer 31

The precise course of many disorders has not been established yet. This is why diagnostic manuals are republished and updated as knowledge on disorders develops. T/F hard to establish predictive validity

Question 32

What is construct validity in terms of diagnosis

Answer 32

The symptoms of the patient match those considered to be present for the disorder and fit the necessary criteria

Question 33

Strength of construct validity for DSM/ICD

Answer 33

Hoffman - Used a computer prompted interview to see if the findings on prison inmates with alcohol dependence/abuse matched the DSM-IV-TR. Symptoms matched DSM diagnosis. T/F DSM-IV-TR has construct validity

Question 34

Weakness of construct validity for DSM/ICD

Answer 34

Rosenhan - All but 1 pseudo patient was diagnosed to have SZ and when released 7 were released with incorrect diagnosis of schizophrenic in remission using DSM 2.

Question 35

2 general validity weaknesses of DSM/ICD

Answer 35

Reductionist - Splits clinical disorders into list of symptoms and features, simplifying complex behaviours, some people may suffer in different ways
Co-morbidity - Hard to diagnose people with multiple disorders as it relies on the clinician choosing the closest match from a list of symptoms.

Question 36

4 AO1 points for cultural issues with diagnosis

Answer 36

The spiritual model
Language barriers
Cultural bound syndromes
Influence of cultural norms and stereotypes

Question 37

What is primary data in clinical psych (4)

Answer 37

Primary data is information collected first hand by the researcher on mental health disorders.
Researcher plans, conducts a study and collects and analyses the data specifically for their research hypothesis
Data collected can be quant or qual
Methods include Observation, experiment and interviews.

Question 38

3 strengths of primary data in clinical psych

Answer 38

Temporal validity - research will be conducted using current DSM criteria to diagnose patients from current population. T/F high external validity, generalisable
Data is fit for purpose - researcher can fully operationalise variables such as mental disorders so data collected is specific and relevant compared to 2nd
Range of data can be collected - qual and quant so analysed in different ways. T/F can produce detailed analysis of clinical disorders so increase validity

Question 39

3 weaknesses of primary data in clinical psych

Answer 39

Pop validity - Hard to get large population of mental health patients and primary research will have small sample due to time and money. T/F unrepresentative…
Practical - The researcher has to plan, acquire collect and analyse which is time consuming and expensive compared to 2nd. T/F not economical
Researcher effect - contact w patient so may influence the patient or their behaviour/response, could lead to demand characteristics.

Question 40

Define secondary data in clinical (4)

Answer 40

Secondary data is the information that already exists where the researcher collects it second hand from an external source on mental health disorder
Data collected can be qual or quant
Its collected by other clinicians for a different purpose and is often readily available
Methods include articles and videos

Question 41

3 strengths of secondary data in clinical psych

Answer 41

Large sample - Easy to collect large population of mental health patients due to range of research being able to be collected easily and efficiently. T/F representative…
Practical - The researcher doesn’t have to plan, acquire collect and analyse meaning its not time consuming and expensive compared to 1st. T/F economical compared
Ethical - Already collected and published so consent already gained. No breach of informed consent

Question 42

3 weaknesses of secondary data in clinical psych

Answer 42

Temporal validity - research is not conducted by researcher so may not be using current DSM criteria to diagnose patients from current population. T/F low external validity, generalisable
Data is fit for purpose - researcher cant fully operationalise variables such as mental disorders as they didn’t collect it so data collected is not specific and relevant compared to primary.
Validity issues with original data - Data already collected so if further data is needed clinician cant do this. Also data may only be quant so analysed in a specific way.

Question 43

What was the aim of Rosenhan

Answer 43

To investigate if sane people could be distinguished from insane people using the DSM2 classification system and if they can be differentiated.

Question 44

What is the sample of Rosenhan

Answer 44

8 pseudo-patients 3 female 5 male

Question 45

What is the procedure of Rosenhan

Answer 45

Pseudo-patients said they could hear unfamiliar voices saying words like empty, hollow and thud
Once admitted to the hospital the pseudo patients behaved normally and reported they were fine and free of symptoms and not schizophrenic
Pseudo patients took notes on their experience covertly but later overtly
When given their medication they threw away their pills or flushed them down the toilet

Question 46

What were the findings of Rosenhan

Answer 46

All but 1 pseudo patient was diagnosed as schizophrenic
35/118 patients recognised the pseudo patients as not crazy
7 were released with diagnosis of sz intermission
Stayed in hospital between 7-52 days average of 19

Question 47

What is the conclusion of Rosenhan

Answer 47

Staff were unable to distinguish those who were sane from those who were insane
Rosenhan argued that the power of a label of insanity leads to the subjective interpretation of any behaviours displayed

Question 48

4 strengths of Rosenhan

Answer 48

Ecological validity - natural setting of 12 varying hospitals in east and west coast of America. TF rep of wrong diagnosed sz using DSM 2
Objective measure - Quant data on pseudo patients was collected for example all but 1 was diagnosed with sz across 12 different hospitals using DSM 2
Mundane realism - took place in realistic setting of a mental hospital as clinicians were unaware so interactions with pseudo-patients were naturally occurring
Changes made to the DSM -

Question 49

4 weaknesses of Rosenhan
MORE AFTER KA

Answer 49

Temporal validity - findings of all but 1 pseudo patients diagnosed as sz was on DSM 2. We us the 5 now. TF outdated and no longer valid
Protection from psych harm - proved incorrect diagnosis using DSM 2 so clinicians may believe they aren’t good enough.

Question 50

How are interviews used in clinical psych (4)

Answer 50

Face to face conversation between a clinician and their patient
This usually will be unstructured or semi structured to gain info on the mental health patient with questions like “what gender are the voices you’re hearing”
This conversation will be recorded and then the clinician will listen and transcribe it.
Finally this transcript will be thematically analysed in depth by clinician to aid diagnosis

Question 51

3 strengths of interviews in clinical psych

Answer 51

In depth data - Rich detailed qual data is gathered by clinician which can be thematically analysed in detail to aid diagnosis. TF internal validity and accuracy
Practical application - Patient may explain symptoms of a mental health disorder which could give insight into new disorders. TF improving society understanding of disorder and improving patients life
Gather qual data - unstructured interviews allow patients to expand during conversations and give more details on the symptoms. TF increasing validity of CI broadening mental health understanding

Question 52

3 weaknesses of interviews in clinical psych
ADD MORE AFTER KA

Answer 52

Subjectivity - Patients transcription will be thematically analysed which may use subjective words and phrases which may be viewed as more important to some clinicians than others. TF less reliable
Time consuming - not practical as its secondary research so researcher has to plan, acquire collect and analyse meaning its time consuming and expensive compared to 1st.

Question 53

What is grounded theory (4)

Answer 53

Glaser and Strauss devised that grounded theory focusses on developing a theory from research evidence. Typically a directional hypothesis so specific info.
Broad codes in the margin of raw data gradually becoming more specific
Data analysed one interview at a time so its possible to introduce info from prior into subsequent.
Aims to develop theories where previously there weren’t any. Often create models.

Question 54

Strength of grounded theory

Answer 54

Evidence is integrated into the theory - as the theory is generated from the evidence being used this means the theory is relevant to making a diagnosis. Therefore, theory has high validity

Question 55

MAKE FLASHCARDS ON REST OF GROUNDED THEORY AND THEMATIC ANALYSIS

Question 56

Aim of Vallentines stud

Answer 56

To investigate the usefulness of psych-ed material provided via group work within secure forensic psychiatric hospitals

Question 57

What was the sample of Vallentines study

Answer 57

42 male patients detained in high security hospital under the mental health act 1983 who had been diagnosed with sz by the ICD 4 - only 21 completed interviews

Question 58

What was the procedure of Vallentines study

Answer 58

Used the CORE-OM interview schedule during group work and the SCQ self report technique to measure self esteem in patients.
31 patients took them with a further 10 dropping out or withdrawing data ending in 21 completers.

Question 59

Conclusion of Vallentines study

Answer 59

Overall sz patients in forensic psychiatric hospitals valued education and knowledge on their illness.

Question 60

Findings of Vallentines study

Answer 60

Over 50% of the 21 completing patients found improvements in behaviour from group work and clinical interviews and gathered quotes like “it gave me peace of mind” and made them feel guilty.

Question 61

2 strengths of Vallentines study
MORE AFTER KA

Answer 61

Standardised questions - used SCQ as self report questionnaires which had repeated questions for all 42 sz patients. TF easy to replicate with similar findings
Qualitative data gathered - semi structured interviews via CORE-OM interview schedule so sz patients could expand on answers to give in depth qual data. Themes generated such as what patients valued and why

Question 62

2 weaknesses of Vallentines study
MORE AFTER KA

Answer 62

Subjective interpretation - researchers analysed interviews and found 4 main themes including what p’pants valued and why. May have been bias to pick themes to support hypothesis. TF lacks internal validity.
Spontaneous questions - semi structured via CORE-OM meant some questions were random and asked different for each sz patient.

Question 63

What are hallucinations (positive)

Answer 63

Cog symptoms and are false perceptions which have no basis in reality. Can be auditory, visual, tactile or somatic. An example of an auditory hallucination is hearing voices in your head telling you to do something.

Question 64

What are delusions (positive)

Answer 64

Cog symptoms which are firmly held false beliefs despite being completely illogical. Can be delusions of grandeur, persecution, reference and control. An example of a delusion of grandeur is believing you a god or have special powers.

Question 65

3 features of sz

Answer 65

According to Jablensky sz is found in any nation at rate of about 1.4-4.6 per 1000. However the prevalence of sz is 1% of population.
Overall there is no gender differences but males usually get it earlier than females do.
The peak incidence for onset of sz is between 17-30

Question 66

What are formal thought disorders (positive)

Answer 66

Involving disturbing and disorganised thought patterns. Includes loose associations which are disorganised/confused ideas and are incoherent when spoken. E.g. shifting from 1 subject to another like moving topic from holiday to dinner randomly.

Question 67

Describe one negative symptom

Answer 67

Social withdrawal - Schizophrenic will not want to interact with other people. This could include not attending school

Question 68

Summarise the diagnosis criteria from the DSM IV-TR for sz

Answer 68

Characteristic symptoms - 2 or more of the following must be present for a significant portion of time during 1 month period: delusions, hallucinations, disorganised speech, grossly disorganised or catatonic behaviour and negative symptoms
Social/occupational dysfunction - failure to achieve expected level of academic or occupational achievement
Duration - disturbance must persist for at least 6 months. Must include at least 1 month of symptoms
Substance/general medical condition exclusion - disturbance not due to direct physiological effects or a general medical condition.

Question 69

What is the aim of Carlsson

Answer 69

To conduct a review of current research to study the relationship between neurotransmitters other than dopamine that could be implicated in causing schizophrenia, specifically glutamate

Question 70

What is the procedure of Carlsson

Answer 70

Reviewed various research findings investigating neurochemical levels in patients diagnosed with sz, drugs used to treat sz and drugs used to induce symptoms of psychosis. Looked at rodents and used PET scans

Question 71

What is the findings of Carlsson

Answer 71

Low levels of glutamate is linked to development of psychosis symptoms, associated with increased dopamine levels.
Glutamate failure in cerebral cortex = negative symptoms
Clozapine is very effective at reducing dopamine

Question 72

What is the conclusion of Carlsson

Answer 72

Schizophrenia may have different types that could be caused by abnormal levels of different neurotransmitters and not just dopamine.

Question 73

2 strengths of Carlsson

Answer 73

Pop validity - Used meta analysis means large and varied sample reviewed such as impact of drugs on their psychosis and treatment. TF increasing generalisability and is representative
Scientific - studies used PET scans when investigating neurotomical levels in sz patients which re very scientific. TF increasing validity o findings that low levels of glutamate links to high dopamine causing sz symptoms

Question 74

2 weaknesses of Carlsson

Answer 74

Secondary data - Carlsson doesn’t know og hypothesis of studies he researched and may have been different to his. No way of knowing it produced valid findings on glutamate and dopamine relationship. TF lacks validity
Anthropomorphic - Used rodents in research not humans.

Question 75

Explain how function of NTs can explain sz

Answer 75

Vesicles release neurotransmitters (dopamine) and travel across the synaptic cleft and bind with receptors on post synaptic neuron, dopamine fires across
Increase in dopamine in 1 site of the brain, contributes to positive symptoms. Whilst problems in the passages connecting the midbrain and frontal lobes contributes to negative sz symptoms.
As well as DA, serotonin, glutamate and GABA all relate to sz. Carlsson found that hypo glutamatergic activity (low levels) of glutamate leads to sz

Question 76

Genetic explanation of sz

Answer 76

If you have a second degree relative (aunt, uncle, grandparent) with sz the risk increases to between 2-6%. If you have a first degree relative risk increases to 6-17%.
MZ concordance rates are a 48% chance you would both be diagnosed compared to 17% concordance rates between DZ
Tiwari suggests rare gene variation of Xq23 has been linked to sz

Question 77

2 strengths of genetic explanation of sz

Answer 77

Gottesman - reviewed 40 twin studies found 48% concordance for MZ and 17% for DZ. Also reported concordance rates for identical twins raised apart and together was very similar. TF not due to being treated same increasing validity
Tienari - adoption studies found 10.3% of adopted children who had sz bio mother developed sz in childhood compared to 1.1% of adopted kids with no sz mother. TF validity

Question 78

2 weaknesses of genetic explanation of sz

Answer 78

Reductionist - only bio genetic factors not nurture like downward drift hypothesis. TF too simplistic
Wahlberg - added on to Tienari saying sz risk was higher if adopted family was high in communication deviancy. TF suggesting influence of environment / nurture

Question 79

Describe social causation hypothesis

Answer 79

Higher incidence of sz in urban settings and in low social classes so those in this category are at more risk of sz
William Eaton suggested city life is more stressful than rural life and long term exposure may make them more vulnerable to sz
The prevalence of sz in immigrant population is higher due to language barriers, stress of moving and employability options
Downward drift hypothesis says those with sz drift to lower class due to the difficulties of sz like attaining jobs and education

Question 80

Explain a bio therapy for sz (4)

Answer 80

Anti-psychotic drugs are drugs which block the effect of dopamine by blovking dopamine receptors
They can be either typical which strongly blocks dopamine or atypical which affects serotonin also
One example of a typical drug is chlorpromazine which blocks dopamine receptors and has side effects of dizziness, dry mouth and blank facial expressions
One example of an atypical drug is risperidone which balances levels of dopamine in brain and works on serotonin to control mood. Side effects of insomnia, severe anxiety and dizziness

Question 81

2 strengths of drug therapy

Answer 81

Schooler - randomly allocated 555 sz patients to treatment of either haloperidol or risperidone and both showed 75% reduction in symptoms. TF increased validity
Fast and effective - Fast and effective compared to CBT in treating sz. Drugs can reduce symptoms within couple of week suggesting cause is biochemical. TF effective for treating first episode of sz

Question 82

2 weaknesses of drug therapy

Answer 82

Reductionist - reduces treatment to NTs like chlorpromazine and not social causes like social class/living conditions TF too simplistic
Only treats symptoms not the cause - If they cease to take medication a lot of symptoms return. TF not effective therapy as need to be on it for rest of life unlike CBT

Question 83

Aim of Bradshaw

Answer 83

Look at how CBT was used to treat a woman with sz including its effectiveness. Use CBT when drug treatment was previously preferred.

Question 84

Sample of Bradshaw

Answer 84

Carol a 26 year old white female

Question 85

Procedure of Bradshaw

Answer 85

Bradshaw conducted a longitudinal case study of Carol, as it tracks Carols progress over 3 years of CBT
Carols symptoms were measured on four scales:
Psychosocial functioning was measured by a Role-Functioning Scale (RFS).
Attainment of treatment goals was measured by a goal-attainment scale looking at how she was functioning.
Hospitalisations were measured by the number of times in hospital.
Development of a therapeutic relationship was also measured.
Stage 1: Rapport developed – self disclosures from therapist used
to build rapport over 3 months
Stage 2: Understanding CBT – 2 months – coping mechanisms of
stress taught using ABC model enabling her to understand emotions
Stage 3: Treatment – Completed weekly activity schedule gradually increased activity & stress management techniques to reduce hallucinations.

Question 86

Findings of Bradshaw

Answer 86

At the end of the study Carol reported few symptoms and little distress.
After 1 year, her RFS score was stable at 27 (she scored 6 at the start) symptoms.
Pre test had 60 hospitalisations in last 3 months but post test was 0

Question 87

Conclusion of Bradshaw

Answer 87

Considerable improvements in all 4 measures after a 3 year
course T/F CBT can successfully treat schizophrenia when
changing automatic negative thoughts and changing
responses to stressful situations.

Question 88

2 strengths of Bradshaw

Answer 88

Eco validity - Bradshaw documented Carols CBT sessions including her symptoms and the effectiveness of CBT. This was Carol’s
genuine treatment and naturally occurring so in the natural setting
Practical application - in knowing a 3 year course of CBT can considerably improve carols functioning we can use this to treat sz. TF improving quality of life for sz

Question 89

2 weaknesses of Bradshaw

Answer 89

Pop validity - studied 26 year old middle class woman but only 1 person completed it. TF sample was unrepresentative of total sz population cant be generalised further as unique case.
Reductionist - only considers role of cognition and how to deal with stress using meditation not bio like hormones. TF too simplistic

Question 90

CBT in clinical AO1 (4)

Answer 90

Assumption of CBT when treating sz is that individual have irrational thoughts and beliefs about themselves and world around them. The aim is not to cure sz but allow patient to function normally
Role of therapist is to accept patients perception of reality and to use it to help manage them. Sessions last 15-60 mins for roughly 2 months.
Socialisation phase is where development of rapport takes place between sz and therapist. Disclose interests and problems to find common ground. Therapy phase understands CBT and focus on coping with stress via ABC.
End phase is 3 months focussed on life without treatment. for homework they have to record beliefs and feelings.

Question 91

2 strengths of CBT for sz

Answer 91

Chadwick -studied 22 sz who heard voices and gave them 8 hours of CBT and all had reduced negative belies about how powerful the voices were. TF effective
Empowers the schizophrenic - in control so they decide on goals they want to achieve and speed of progress.

Question 92

2 Weaknesses of CBT for sz

Answer 92

Time consuming and expensive
Kingdom and Turkington - 30% deteriorate during CBT

Question 93

Cultural issues - the spiritual model

Answer 93

Lack of understanding of one culture to another
If clinician is from a different cultural background to patient some of their behaviours may be interpreted as abnormal when they aren’t
Malgady found the difference in hearing voices in costa Rica vs USA as in Costa Rica its interpreted as ancestors speaking to you and you will be admired but in US its a symptom off SZ.
Littlewood and Lipsedge found cultural bias can lead to subjective interpretation as Rastafarian Calvin was arrested and seen as eccentric and abnormally behaved however normal in his culture. TF no universal definition of abnormal as definition is ethnocentric

Question 94

Cultural issues - Language barriers

Answer 94

When clinician and patient have different native languages and are using a common language which is less easy for one or both to understand during diagnosis
May impact clinicians understanding of the symptoms if they description doesn’t translate to the therapists native language.
TF resulting in misdiagnosis or potentially no diagnosis

Question 95

Cultural issues - Culturally bound syndromes

Answer 95

Illnesses with a set of symptoms found and recognised as an illness in only 1 culture leading to different diagnosis in other cultures. E.g. native americans tribes see symptoms of nightmares, obsession with death and loss of appetite is ghost sickness but this isnt recognised universally. TF misdiagnosis or no diagnosis if not recognised universally.

Question 96

Cultural issues - cultural norms and stereotypes

Answer 96

Leads do different diagnosis in different countries due to different beliefs about mental health disorder which leads to individual differences when diagnosing. Cooper examined 250 psychiatric admissions in NYC and London. DSM 2 found NYC schiz is 8x more frequent than bipolar but London was 1:1. TF same symptoms result in different diagnosis.