Psychological Therapies Flashcards
Cognitive-behavioural therapy
The basic assumption is that distorted beliefs alter peoples behaviour in maladaptive ways. Delusions are thought to be a result from faulty interpretations of events and CBT is used to help the patients identify and correct these. Thinking processes are the cause of schizophrenia as it is the mechanisms that filter and process incoming stimuli that are defective in their brains leading to information overload. The way people perceive and process information is the problem. For example, hallucinations are a result of information overload as the brain struggles to deal with the information. Turkington said the purpose is to help patients make sense of how their environment (delusions and hallucinations) impacts on their feelings and behaviour.
CBT techniques
Patients are encouraged to trace back their origins in order to get a better idea of where the symptoms have come from. They are encouraged to evaluate the content of their delusions and consider ways to test their validity of their faulty beliefs. The patients develops their own alternative to the maladaptive beliefs that come with distorted thinking and to chose their own coping strategies.
Outcome studies
These measure how well a patient does after a particular treatment. Those who receive CBT experience fewer hallucinations and recover their functioning to a greater extent than those who receive medication alone. Drury found a reduction of 25-50% in recovery time and a reduction in positive symptoms in patients given CBT and antipsychotic drugs. Kuipers confirmed these advantages and also reported lower-patient drop out rates and greater patient satisfaction when used in addition to medication.
EVALUATION:
Effectiveness of CBT:
Supporting research:
Gould found that all 7 studies in a meta-analysis reported a decrease in positive symptoms after CBT. Showing that it is effective in improving the symptoms of those with schizophrenia.
EVALUATION:
Effectiveness of CBT:
How much is due to the effects of CBT alone?
Most patients are assessed with CBT alongside medication making it difficult to test the effectiveness of CBT alone. So CBT may not be as effective when used by itself.
EVALUATION:
Appropriateness of CBT:
Negative symptoms:
CBT generates less distressing explanations for psychoti experiences rather than trying to eliminate them completely. Negative symptoms are seen as ‘safety behaviours.’ Withdrawal may be seen as a way of avoiding making positive symptoms worse. So CBT offers a hope of alleviating the thought processes. However, does it need to cure schizophrenia in order for it to be appropriate? it helps people live better lives.
EVALUATION:
Appropriateness of CBT:
Who benefits?
CBT has been shown to not be appropriate for everyone. For example, older patients are deemed less suitable, reducing it’s appropriateness.
Psychodynamic therapies
Based on the assumption that individuals are unaware of the influence the conflict in the unconscious has on their current state of well-being. The aim is the bring the unconscious thoughts into the co nscious mind in order for them to be dealt with.
Psychodynamic techniques
The therapists attempts to create an alliance with the patient in order for them to be able to release the unconscious conflict into the conscious mind. However, Freud believed that schizophrenics cant shift the conflict because they do not have the transference (emotions associated with one person) with the analyst.
Other forms of psychoanalysis have been found to be successful with the first task being to win trust and build a relationship with the client. They do this by replacing the harsh conscience with a less destructive one. As the patient gets healthier, they take a more active role in their sessions.
EVALUATION:
Effectiveness of psychodynamic therapy:
Supporting research:
It has been argued that it is impossible to draw definite conclusions on whether the psychodynamic approach is effective or not because it can never be proven. It has also been argued that the therapy is harmful because t involves patients having to bring up the past which may prove to be harmful. Despite this a meta-analysis found that overall 66% of those on the treatment improved compared to 35% of those not the treatment, suggesting it is an effective form of therapy,
EVALUATION:
Effectiveness of psychodynamic therapy:
Contradictory findings:
May found that those treated with psychodynamic therapy and medication had better outcome. Some even found medication to be superior alone. However, Karon and Vander Bros found the opposite with those on therapy improving more than medication alone. suggesting a combination of biological and psychological for the case of schizophrenia.
However, there are methodological problems-
Small sample size and Lack of random allocation
EVALUATION:
Appropriateness of psychodynamic therapy:
Combination theory:
When therapy and medication are combined it is seen as an appropriate treatment. The American Psychiatric Association support this and they are a big company who promote hr highest quality care and so they are a trusted opinion. So they treatment is seen as an appropriate treatment when combined but may not be so when alone.
EVALUATION:
Appropriateness of psychodynamic therapy:
Costs and benefits:
Some would argue that because the treatments are combined, it is not worth the extra expense (therapists are expensive.) So it is not appropriate. Karon and Vander Bros found the costs actually decrease because patients are less likely to seek inpatient treatments and so are more likely to be able to be employed and so helping the economy too. So it is an appropriate treatment because the cost-benefit analysis is positive.
What are the 4 evaluation points for CBT?
Supporting research
How much is due to the effects of CBT alone?
Negative symptoms
Who benefits
What are the 4 evaluation points for psychodynamic?
Supporting research
Contradictory findings
Combination theory
Costs and benefits
