LS5 - Psychological Therapies For SZ

Question 1

Cognitive Behavioural Therapy

Answer 1

Provides treatment for residual symptoms that persist despite drug therapy.

Question 2

Phases Of Cognitive Behavioural Therapy

Answer 2

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

Question 3

How Is CBT Done?

Answer 3

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

Question 4

CBT Strengths (+)

Answer 4

More Effective Compared To Drug Therapy
Effectiveness Is Dependent On Stage Of Disorder

Question 5

CBT Weaknesses

Answer 5

Lack Of Availability/Refusal
Problems With Meta-ANalysis

Question 6

More Effective Compared To Drug Therapy (+)

Answer 6

NICE reviewed treatments and found CBT was best in reducing rehospitalisation, it was also best in reducing the severity of the symptoms.

Question 7

Effectiveness Depends On Stage Of Disorder (+)

Answer 7

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..

Question 8

Lack Of Availability/Refusal (-)

Answer 8

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.

Question 9

Problems With Meta-Analysis (-)

Answer 9

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.

Question 10

Family Therapy

Answer 10

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.

Question 11

How Does Family Therapy Work?

Answer 11

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

Question 12

Pharaoh Et Al Family Therapy Study

Answer 12

Reviewed 53 studies across different countries to study effectiveness of family intervention, the studies compared family intervention to drug therapy.

Question 13

Pharaoh Et Al Results

Answer 13

Family therapy increases patient’s compliance with medication, Showed better day-to-day functioning, There was also a reduction in relapse.

Question 14

Family Therapy Evaluation

Answer 14

Lack Of Blinding
Pharaoh Results
Economical Benefits
Good Impact On Relatives

Question 15

Lack Of Blinding (-)

Answer 15

In the meta-studies analysed, all researchers knew whether participants were in the experimental or control conditions, creating rater bias.

Question 16

Pharaoh Results (+)

Answer 16

The main message from Pharaoh’s analysis was that it increased compliance with medication and was successful

Question 17

Economical Benefits (+)

Answer 17

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.

Question 18

Good Impact On Relatives (+)

Answer 18

Family therapy consistently benefits other relatives in different categories e.g. coping, problem-solving, family functioning and relatinoship quality.

Question 19

Token Economy

Answer 19

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.

Question 20

Tokens

Answer 20

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.

Question 21

Rewards

Answer 21

The tokens can be swapped for more tangible rewards.

Question 22

Token Economy Strengths

Answer 22

Research Support

Question 23

Token Economy Weaknesses

Answer 23

Ethical Issues
Lacks ecological validity
Does It Actually Work?

Question 24

Research Support Token Economy (+)

Answer 24

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.

Question 25

Ethical Issues (-)

Answer 25

Clinicians may exercise control over vital primary reinforces e.g. food, privacy or games, meaning basic rights may be taken away.

Question 26

Lacks Ecological Validity (-)

Answer 26

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>