Methods Of Modifying (2) CBT

Question 1

Aims of CBTp

Answer 1

Aims to alter the way in which a person thinks and help them manage their disordered thinking - it cannot prevent delusions or hallucinations but can help the patient understand/cope with them

Question 2

Components of CBTp

Answer 2

Assessment:
Client and therapist meet for the first time
Client explains their symptoms/experiences
Goals/expectations for the therapy are established

Engagement:
Client can talk at length about their worries and symptoms
Build a rapport
Therapist will empathise with paitents feelings
Will then discuss coping strategies they’re currently using

Question 3

Psychoeducation/normalisation

Answer 3

Therapist normalises the experience of psychotic symptoms making them feel less stigmatised
Helps to increase the clients understanding of the context in which symptoms occur
Also helps the therapist to assess the sz’s understanding of their symptoms

Question 4

Cognitive strategies (5)

Answer 4

3 examples:
-relapse prevention
Therapist and client identify warning signs of relapse e.g identifying feelings before they was unwell and assess how well they got on with others before - they then develop a plan which they take when they notice these indicators
-dysfunctional though diary
Client keeps a record of how they feel and what they did and write down automatic negative response - therapist then challenges them to think differently and record different views using evidence
-skills training
Strategies like relaxation and pleasant activity scheduling are taught - these are employed to cope with symptoms not managed by medication e.g depression

Question 5

Evaluation - effectiveness

Answer 5

S-strength as there is research support
E-50% improvement compared to controls only 1 worsened only 30% improved in controls
C-however results are marginal only 50%
W-CBT is more effective at modifying sz than standard care alone (controls)

Question 6

Evaluation - effectiveness

Answer 6

S-effectiveness in the long term is questionable
E-18m later the cbt group had the same relapse rate as the control group receiving standard care suggesting the effects of cbt are short lived
C- could be argued that individuals in the cbt condition seemed to be less negatively effected by their symptoms than controls
W-suggests that there are some long term benefits but it depends on how such benefits are assessed

Question 7

Evaluation - ethics - strengths

Answer 7

-client has more control over therapy (more input can boost self esteem)
-no side effects compared to antipsychotics

Question 8

Evaluation - ethics - weakness

Answer 8

-blaming the patient for sz by telling them their thinking is wrong
-psychiatric prejudice as some may not be considered for cbt and only prescribes antipsychotics

Question 9

Evaluation - social implications - strengths

Answer 9

-giving the patient coping strategies to allow them to live a ‘normal life’ makes having sz less intrusive to daily life so they can return to work and be contributing members of society

Question 10

Evaluation - social implications - weakness

Answer 10

-cbt can be intrusive to an sz patient as attending therapy, doing hw may not suit a daily routine so may have to miss work
-cbt often used in conjunction with antipsychotics- cbt is costly and has high drop out rates
-not all nhs trusts offer cbt + long waiting lists