cognitive treatment of SZ Flashcards
CBT does not aim to cure schizophrenia but allow the patient to function more normally.
One-to-one sessions usually take place weekly for a number of weeks; the therapist tries to build up a trusting, supportive relationship with the patient so they feel comfortable.
It involves helping patients identify irrational and unhelpful thoughts and trying to change them.
Using the ABC model the therapist identifies the patient’s perceptions, linking the activating events with the consequences.
The therapist engages with the patient in identifying the sources of distress for the individual such as hearing voices.
The therapist has to accept the patient’s perception of reality and then use this misperception to help the patient manage.
Understanding where symptoms originate may be crucial for some; e.g. if a patient hears voices and believes they are demons, they will naturally be afraid. Offering a range of explanations for the existence of hallucinations and delusions can help reduce this anxiety.
There are many CBT approaches; e.g. belief modification is where delusional thinking is challenged directly and tested against reality.
Another technique is focusing and reattribution which looks at auditory hallucinations with the aim of reducing their frequency and the distress caused. The therapist will focus on the physical attributes of the voices (e.g. tone, loudness), then the content, and then finally the beliefs about those voices.
Sometimes the therapy will focus on the distress experienced and coping mechanisms (rather than specific symptoms).
+ve Several studies support the success of CBT e.g. Gould et al 2001 conducted a meta-analysis and found CBT to be effective at treating the positive symptoms of hallucinations and delusions
+ve The therapy can help to treat other problems associated with schizophrenia such as stress and depression which is useful as schizophrenics are often comorbid with these disorders.
+ve It is non-threatening and supportive and the patient has more power (compared to drug therapy) so it is more ethical.
-ve It may be distressing for some as patients are asked to focus on distressing symptoms and asked to question their beliefs.
-ve The studies testing the effectiveness of CBT are often done without control conditions or competing therapies, so there is no comparison to judge how effective it is.
-ve Psychodynamic psychologists might criticize CBT for not getting to the root cause of the problem; it tries to alter irrational thoughts but doesn’t address what caused the irrational thoughts in the first place.
