LS5 - Psychological Therapies For SZ Flashcards
Cognitive Behavioural Therapy
Provides treatment for residual symptoms that persist despite drug therapy.
Phases Of Cognitive Behavioural Therapy
Assessment - Realistic Goals
Engagement - Empathises With Patient
The ABC Model - Explains through ABC
Normalisation - Bare mans have unusual experience
Critical Collaborative Analysis - Help them understand illogical deductions.
Developing Alternative Explanations
How Is CBT Done?
In groups but better 1 to 1
16 sessions is recommended
Tests validity of their unusual experiences
Allows the patient to think of their own alternative explanations
CBT Strengths (+)
More Effective Compared To Drug Therapy
Effectiveness Is Dependent On Stage Of Disorder
CBT Weaknesses
Lack Of Availability/Refusal
Problems With Meta-ANalysis
More Effective Compared To Drug Therapy (+)
NICE reviewed treatments and found CBT was best in reducing rehospitalisation, it was also best in reducing the severity of the symptoms.
Effectiveness Depends On Stage Of Disorder (+)
It’s best when it’s made available at certain stages and tailored to the individual. Once the symptoms have stabilised and they are on medication, the patients can benefit best from CBT especially in a group..
Lack Of Availability/Refusal (-)
Only one in ten schizophrenics actually have access to CBT, and then a lot of those people that are offered it deny it, limiting it’s effectiveness.
Problems With Meta-Analysis (-)
Meta-analysis fail to take into account the quality of the studies e.g. some studies fail to randomly allocate participants to CBT or a control condition.
Family Therapy
Provides support for carers in an attempt to make family life less stressful and reduce rehospitalisation, it’s offered for 3-12 months, and at for at least 10 sessions, they try to reduce the level of expressed emotion within the family as it can increase relapse.
How Does Family Therapy Work?
Psychoeducation
Forming An Alliance With Relatives
Reducing Emotional Climate/Burden Of Care
Enhance Problem Solving
Reduce Expressed Guilt/Anger
Maintain Reasonable Expectation
Set Appropriate Limits
Pharaoh Et Al Family Therapy Study
Reviewed 53 studies across different countries to study effectiveness of family intervention, the studies compared family intervention to drug therapy.
Pharaoh Et Al Results
Family therapy increases patient’s compliance with medication, Showed better day-to-day functioning, There was also a reduction in relapse.
Family Therapy Evaluation
Lack Of Blinding
Pharaoh Results
Economical Benefits
Good Impact On Relatives
Lack Of Blinding (-)
In the meta-studies analysed, all researchers knew whether participants were in the experimental or control conditions, creating rater bias.
Pharaoh Results (+)
The main message from Pharaoh’s analysis was that it increased compliance with medication and was successful
Economical Benefits (+)
The extra cost of family therapy is offset by a reduction in costs of hospitalisation, due to lower relapse rates. Relapse rates are also reduced significantly after family intervention, meaning a greater economical benefit.
Good Impact On Relatives (+)
Family therapy consistently benefits other relatives in different categories e.g. coping, problem-solving, family functioning and relatinoship quality.
Token Economy
Rewards systems to manage the behaviour of patients with SZ in hospital settings, it helps cure bad habits like hygiene and not changing clothes, which will improve quality of life. It’s linked to operant conditioning.
Tokens
e.g. forms of coloured discs after they perform a task, the behaviour is tailored to each patient, the tokens are immediately given to the patient for operant conditioning to occurr.
Rewards
The tokens can be swapped for more tangible rewards.
Token Economy Strengths
Research Support
Token Economy Weaknesses
Ethical Issues
Lacks ecological validity
Does It Actually Work?
Research Support Token Economy (+)
13 studies using token economies were reviewed, and 11 had reported beneficial effects due to the token economies, providing evidence that token economy is effective.
Ethical Issues (-)
Clinicians may exercise control over vital primary reinforces e.g. food, privacy or games, meaning basic rights may be taken away.
Lacks Ecological Validity (-)
It has only proven to be effective in hospital settings, in the real world who will give people tokens straight away and where will they trade them>
