lec 4

Question 1

psychosis

Answer 1

loss of contact with reality
positive symptoms (hallucinations, delusions) and negative symptoms (flat affect, avolition, lack of interest in social interactions).

Question 2

psychological therapies for psychosis

Answer 2

Rogerian/person-centred therapy.

Psychoanalytic therapies.

Cognitive Behaviour Therapy (CBT)

Family therapy.

Interventions to reduce substance misuse

Question 3

what is CBT

Answer 3

Activating event -> thought (negative automatic thoughts, thought distortions, appraisals)
-> behaviours -> feelings/emotions

Question 4

Cognitive Behaviour Therapy for Psychosis (CBTp)

Answer 4

Establish links between, thoughts, beliefs, perceptions and feelings in relation to their current or past symptoms and/or functioning
Re-evaluate their beliefs, perceptions and reasoning relating to target symptoms.
CBTp should involve development alternative ways of coping with the target symptoms, and/or reduction of distress, and/or improvement of functioning.

Question 5

startegies of cbtp - 4

Answer 5

Formulating (making sense).

Normalising psychosis.

Improving coping.

Strategies to change unhelpful thoughts, beliefs, and appraisals.

Question 6

formulating - link

Answer 6

after identifying appropriate goals for therapy:
Identify thoughts, feelings, behaviours that are linked to the problem/symptom targeted.
Help the client to see how these interact to maintain the problem in the present.
Create a shared understanding of how the problem developed and what could be done to resolve it.

Question 7

normalisation

Answer 7

Challenging the stigma of psychosis.
Correcting common misconceptions about psychosis, its causes and its consequences.
Making the experience understandable:

Question 8

reoccurance of psychosis

Answer 8

single episode that never occurs again (about 30%).
more than one episode even after long periods of being symptom-free (about 30%).
A minority of people have persistent ongoing symptoms (< 25%).

Question 9

how to improve coping - reviewing strat

Answer 9

Review strategies the client already uses to cope with psychotic experiences, how often/when they are used and how effective they are.
Encourage the client to experiment with new coping strategies

Question 10

aim of coping strategies (3)

Answer 10

(1) increase the coping strategies the client can use when facing distressing symptoms;
(2) provide some respite;
(3) encourage a greater sense of control.

Question 11

Challenging unhelpful beliefs

Answer 11

negative beliefs about psychosis strongly predict distress and impairment

Question 12

strategies for challenging unhelpful beliefs

Answer 12

Possible strategies:
Use Socratic questioning in session.
Ask clients to keep a log of recent voice hearing experiences.
Behavioral experiment  if you do… what will happen?
Evidence/counterevidence analysis.

Question 13

efficacy of CBTp

Answer 13

CBTp can be effective on its own, even in individuals who are not taking antipsychotic
medication.

meta-analyses have shown that CBT can alleviate psychotic symptoms, especially positive symptoms.

Over 50 RCTs have examined the efficacy of CBT in people with
psychosis, with positive findings across most “stages” of psychosis