Cognitive Behavioural Therapy For SZ

Question 1

What is CBT in sz

Answer 1

Psychological treatment - addresses both the cognitive and behavioural issues of sz simultaneously.
AIM = help pts identify their faulty, delusionary beliefs + reduce stress associated with symptoms of sz + developing rational constructive ways of thinking, coping, functioning.

Question 2

What are the 2 techniques used in CBT

Answer 2

IPT - integrated psychological therapy (CHADWICK)
Improve attention + refine concept information - identify specific cognitive deficits - resolve in a non-confrontational manner
taught to respond and recognise appropriately to social cues - combat inappropriate effect
understand verbal statements more accurately - combat alogia)
engaging group excercises - repetitive training (rehearsal practice) to refine new behavioural tactics

CSE - coping strategy enhancement (TARRIER)
ways to manage severity and frequency of symptoms
reduce stress that impacts day to day Thorough behaviour analysis of each symptom = use of appropriate coping strategies
Cognitive strategies - distractive thoughts and positive self talk “you can do this”
Behavioural strategies - relaxation techniques to drawn hallucinatory voices.
TARRIER - 73% sample reported they were successful at managing symptoms.

Question 3

Positive EV for CBT sz

Answer 3

Research - STARTUP 90 pts who had been admitted to hospital with an acute episode (sz) - 43 (control group) given standard care - APs and nursing care - and 47 given standard care plus 25,90 min sessions of CBT.
60% CBT group showed improvement compared to 40% control group - stood the test of time and remained at 6 and 12 month follow ups = CBT is effective treatment option

Question 4

Negative EV CBT sz

Answer 4

Criticism from clinicians - characteristically don’t have coherent thinking and insight into their condition to gain therapeutic benefit.
KINGDON + KIRSCHEN found clinicians judged older sz pts as being less suitable to benefit from CBT
= CBT not be suitable for all patients

Appropriateness questioned - pts may suffer from different sz symptoms.
ZIMMERMAN found CBT helps with auditory and visual hallucinations and helps particularly with distress and negative emotions experienced
HOWEVER - less helpful treating negative symptoms (flat effect)
= CBT limited usefulness