psychological therapies Flashcards
what types of therapy are used for cognitive explanation / family dysfunction in Sz
CBT (CBTp)
Family therapy
what is involved in CBT
RENT:
Recognising
Educating
Normalising
(reality) Testing
what is R from RENT in CBTp
Recognising: in CBT patients are taught to recognise examples of dysfunctional/delusional thinking,
can patients then can be helped on how to avoid acting on the thoughts
what is E from RENT in CBTp
Educating, explaining to a patient where their symptoms come from eg malfunctioning brain areas. this stops patients believing the voices can hurt them, reducing anxiety
What is N from RENT in CBTp
Normalising, helping the patient realise that the disrupted thoughts are normal in some situations, that the voice is an extension of the ordinary experience of thinking in words. therefore no need to feel stressed or ashamed
What is T from RENT in CBTp
reality Testing, where the therapist and patient test whether a belief is actually true, asking for proof of the patients delusions etc, allowing for some regained perspective and reduced anxiety
what’re 2 strengths of CBTp
- evidence from a meta-analysis
- NICE clinical advice
how is a meta-analysis a strength of CBTp
- evidence supporting CBT’s effectiveness for Sz
- Jauhar et al reviewed 34 studies where CBT was used with Sz and found clear evidence for small but significant effects on both positive and negative symptoms
- unlike biological drug approach lowering dopamine levels, treating positive symptoms like hyperdopaminergia but not low level symptoms
- strength of CBTp
how is NICE clinical advice a support for CBTp
- Pontillo found that CBT caused reductions in frequency and severity of auditory hallucinations
- National Institute for health and Care Excellence, (NICE), recommends CBT for Sz
- means that both research and clinical experience support CBT’s use for Sz
what’re 2 neg evals of CBTp
wide range of techniques used
palliative not curative
how is CBT’s wide range of techniques a neg eval
- Thomas points out that different studies have used different CBT techno and have people with different symptoms (some positive, some neg and inbetween)
- this is a limitation as the process isn’t standardised and therefore does not work for everyone the same
how is CBT being palliative and not curative a neg eval
- Sz is likely biological in origin, therefore psychological therapies may only help the patient live a normal life and cope with symptoms
- this may be a problem as the source problem isn’t addressed
- however the palliative treatment may be enough for some people
what’re the 2 strategies behind family therapy
- reduces negative emotions
- improves the family’s ability to help
what’re the 7 stages of family therapy for Sz
B R S C S R M:
- Basic information
- Identifying resources that can/can’t be offered
- Safe space encourages
- Communication, identifying unhelpful behavioural patterns
- Skills training, such as stress management techniques
- Relapse prevention
- Maintenance for the future
what’re 3 strengths for family therapy
- supporting evidence
- benefits the whole family
- economic benefits
what is supporting evidence for family therapy
- McFarlane concluded that Sz relapse rates were reduced by 50-60% for family therapy
- particularly promising when mental health initially starts to decline. NICE recommends family therapy
- strength as people can return to work/normal lives with less worries of relapse, moreover with little to no side effects
how does family therapy benefit the whole family
- is also for the family to provide the main care for people with Sz
- family therapy lessens the impact of Sz on the family and gives them more of an ability to give support
- strength as it reduces the negative effects on 3rd parties in the family, creating a better environment for the family in addition to the patient
what’re economic benefits of family therapy
- reduces relapse rates and makes families provide the bulk of care so has economic benefits
- reduces the amount of time patients need to spend in hospital and costs less to the (NHS) economy
what’re 3 differences between family therapy and drug therapy
- family therapy is Palliative rather than Curative
- Family therapy is more expensive to the NHS than the creation of pills in drug treatments
- family therapy has no side effects (like agranulocytosis from clozapine or narcoleptic malignant syndrome and facial spasms from chlorpromazine)
