Psychological Therapies

Question 1

Cognitive behavioural therapy (CBT) assumes that…?

Answer 1

Schizophrenia is the result of dysfunctional though processes
E.g faulty cognitions such as delusions are identified with CBT change

Question 2

What is the therapists role?

Answer 2

To challenge the irrational beliefs
E.g logically disrupting the reality of delusions and helping develop alternatives.

Question 3

What model was proposed by Ellis?

Answer 3

ABC(DE) model: Used to understand the source of faulty cognition and provide a process to cognitively restructure irrational beliefs (delusions)

Question 4

Outlines the processes used in the ABC(DE) model

Answer 4

A - Activating event (Drug treatment causes side effects)
B - Beliefs (Hospital staff are trying to kill them)
C - Consequences (Refusing treatment)
D - Disrupting irrational beliefs (logical) (Staff have no reason to kill them)
E - Restructured belief (Effect) (Drugs are necessary)

Question 5

What is reality testing?

Answer 5

Process in which the patient can demonstrate for themselves that their irrational thoughts are not real.

Question 6

AO3+ Supporting Research (CBT)

Answer 6

Supporting research is provided by Sensky et al (2000) who showed that patients who had resisted drug treatments, had a reduction in positive and negative symptoms when treated by 19 sessions of CBT. Also they continued to improve even 9 months after the treatment had ended. This suggests that CBT can be effective when drugs are not, but also are an improvement on drug therapies as drugs only reduce symptoms in the short term

Question 7

AO3- Non-supportive research (CBT)

Answer 7

Ending treatment early is common due the length of the treatment, symptoms may become severe in this time. CBT requires engagement, negative symptoms can lead to an unwillingness to take part, or positive leading to distrust of the process

Question 8

AO3- Non-supportive research (CBT)

Answer 8

Some patients, due to severity of symptoms or personality may not be able to cope with the vigorous confrontation of beliefs that CBT requires. In this case, anti-psychotic medication can be used first to reduce the severity of the symptoms

Question 9

AO3 Either way

Answer 9

CBT does not produce the side effects of drug therapies making it a preferred treatment plan for many patients. However the significant cost of working with a trained therapist over multiple sessions means drug therapy is more common

Question 10

Family therapies
What can increase the risk of relapse into schizophrenia?

Answer 10

Family dysfunction

Question 11

What do family therapies attempt to perform?

Answer 11

Attempt to improve the home situation of the person with schizophrenia.

Question 12

Family therapies are?

Answer 12

Family centred, it intends to change the behaviour of the whole family not just the person with schizophrenia.

Question 13

Psychoeducation.

Answer 13

Family is dedicated on the symptoms of schizophrenia in order for them to be more understanding of their family members behaviour.

Question 14

How does family therapy work in general?

Answer 14

Reduces Conflict by addressing anger within their family
Reduces Stress caused by caring responsibilities
Reduce Self Sacrifice by getting carers to consider their own needs
Improve communication: How to limit expressed emotion
Improve problem solving skills: predicting problem, having solution ready

Question 15

AO3+ Supportive research (Family therapy)

Answer 15

There is supporting research from Leff (1985) who looked at the aftercare of patients with schizophrenia. Of those that were provided with standard outpatient care, 50% had relapsed within 9 months, compared to only 9% who received family therapy. However after two years this had risen to 50% with family therapy and 75% with standard outpatient care. This suggests that the use of family therapy is helpful in reducing re-admission in the short-term, however families may not maintain positive patterns of behaviour over the longer term.

Question 16

AO3- Supportive research (Family therapy_

Answer 16

There are problematic practical issues such as the length of therapy. Family therapy can often take up to a year. During this time patients may drop out, especially if they have a particularly severe symptoms or family incident

Question 17

AO3- Supportive research (Family therapy)

Answer 17

Family therapy is about improving symptoms, aiding the home life of the family ultimately avoiding admission to a mental health facility. However it is not a cure for the disorder. While more manageable, symptoms remain.

Question 18

Token economies
Who did they come from?

Answer 18

BF Skinner and Operant Conditioning

Question 19

What are tokens used for for?

Answer 19

Positive reinforcement, an immediate reward for when the patients shows more defined target behaviour. Tokens are then exchange for something else that they want

Question 20

Token economy system:
Behaviour shaping

Answer 20

Behaviours are progressively changed with tokens first given for small changes in behaviours towards the ideal.

Question 21

Token economy system:
Psychiatric institutions:

Answer 21

Treatment is designed to produce easier to manage behaviour within the hospital, or to prepare long stay patients for transfer into the community.

Question 22

Token economy system:
Mild negative symptoms

Answer 22

Treatment can be used for patients with mild symptoms, but more profoundly ill patients are less able or willing to engage

Question 23

AO3 Support (Token economy system)

Answer 23

Evidence by Dickerson (2005) who found when reviewing the findings of 13 studies, token economies can be effective in improving the adaptive behaviour of people with schizophrenia

Question 24

AO3 Un-supportive (Token economy system)

Answer 24

Token economies do not directly treat symptoms of schizophrenia, they only attempt to manage negative symptoms such as poor motivation, poor attention and social withdrawal.

Question 25

AO3 Un-supportive (Token economy system)

Answer 25

Not effective with severely unresponsive patients such as those with very strong negative symptoms, this could be seen as punishment for illness.