Cognitive therapy

Question 1

Cognitive behavioural therapy for psychosis (CBTp)

Answer 1

Aim to help people establish links between their thoughts, feelings or actions and their symptoms and general level functioning

Question 2

How does CBTp work?

Answer 2

1. Assessment
2. Engagement
3. The ABC model
4. Normalisation
   5, Critical collaborative analysis
5. Developing alternative explanations

Question 3

What are paitents encouraged to do in CBTp?

Answer 3

They are encouraged to trace back to the origins of their symtptoms to get better idea of how they might have developed. They might be set behavioural assingments to improve their general level of functioning.

Question 4

What does the therapist do?

Answer 4

The therapist lets the paitents development their own alternatives to these maldaptive beliefs, looking for alternative explanations and coping stratefies that are already present in the paitent’s mind.

Question 5

Assessment

Answer 5

The paitent expresses their thoughts about their experiences. Realistic goals for therpay are discussed

Question 6

Engagment

Answer 6

Thr therapist empathises with the paitent’s perspective and their feelings of distress, and stress that explanations for their distress can be developed together.

Question 7

The ABC model

Answer 7

The paitent gives their explanation of the activating event that cause their distress. These beliefs can then be rationalised, disputed and changed

Question 8

Normalisation

Answer 8

By placing psychotic experiences on a continuum with normal experiences, the paitent feels like alliented and the possibility of recovery seems more likely.

Question 9

Critical collaborative analysis

Answer 9

The therapist uses genetle questioning to help the patient understamd illogical deductions and conclusions

Question 10

Developing alternative explanations

Answer 10

The paitent develops their own alternative explanations for their previously unhealthy assumptions in cooperation with the therapist.

Question 11

AO3

Question 12

Advantages of CBTp over standard care

Answer 12

P: The NICE (2014) review of treatments for Sz found that compared to antipsychotic medication, CBTp was more effective in reducing rehospitalisation.

E: CBTp was also effecting in reducing symptom severity and when compared with paitents recieving standard care, there was evidence for improvements in social functioning.

E: However, most studies have been conducted with paitent treated at the same time with antipsychotic medication. It is difficult, therefore, to assess the effectiveness of indepent of this medication

Question 13

The benefits of CBTp may have been overstated

Answer 13

P: More methodologically sound meta analyses of the effectiveness of CBTp as a sole treatment suggest that its effectiveness may actually be lower than orginally thought.

E: One recent large-scale meta analysis (Jauhar et al 2014) revealed only a smal theraputetic effect on key symps of Sz such as hallucinations and delusions.

E: This uncertanity of the effectiveness of CBTp is similar to antipsychotic medication has led to conflicting recommendations within the UK about its use as treatment for Sz.

Question 14

Effectiveness of CBTp is depend on the stage of the disorder

Answer 14

P; CBTp appears to be more effective when it is made avaliable at a specific stage of the disorder.

E: In the inital phase of Sz self-flectional is not particulary effective. Following stabillisation of the psychotic symptoms with antipsychotic medication, however, indiviuals are more likely to benefit from CBTp

E: Therefore individuals with more experiences of their SZ and a greater realisation of their problems that benefits more from CBTp.