psychological therapies

Question 1

what types of therapy are used for cognitive explanation / family dysfunction in Sz

Answer 1

CBT (CBTp)
Family therapy

Question 2

what is involved in CBT

Answer 2

RENT:
Recognising
Educating
Normalising
(reality) Testing

Question 3

what is R from RENT in CBTp

Answer 3

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

Question 4

what is E from RENT in CBTp

Answer 4

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

Question 5

What is N from RENT in CBTp

Answer 5

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

Question 6

What is T from RENT in CBTp

Answer 6

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

Question 7

what’re 2 strengths of CBTp

Answer 7

• evidence from a meta-analysis
• NICE clinical advice

Question 8

how is a meta-analysis a strength of CBTp

Answer 8

• 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

Question 9

how is NICE clinical advice a support for CBTp

Answer 9

• 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

Question 10

what’re 2 neg evals of CBTp

Answer 10

wide range of techniques used
palliative not curative

Question 11

how is CBT’s wide range of techniques a neg eval

Answer 11

• 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

Question 12

how is CBT being palliative and not curative a neg eval

Answer 12

• 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

Question 13

what’re the 2 strategies behind family therapy

Answer 13

1. reduces negative emotions
2. improves the family’s ability to help

Question 14

what’re the 7 stages of family therapy for Sz

Answer 14

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

Question 15

what’re 3 strengths for family therapy

Answer 15

• supporting evidence
• benefits the whole family
• economic benefits

Question 16

what is supporting evidence for family therapy

Answer 16

• 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

Question 17

how does family therapy benefit the whole family

Answer 17

• 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

Question 18

what’re economic benefits of family therapy

Answer 18

• 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

Question 19

what’re 3 differences between family therapy and drug therapy

Answer 19

• 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)