Psychological Therapies: CBT Flashcards
What are the uses of CBT for schizophrenia?
NICE recommend, may be that patients also require drugs if symptoms are severe, easily applied to negative symptoms but also used for positive symptoms
What is the rationale and aim of using CBT for schizophrenia?
schizophrenia caused/maintained by beliefs that patients have about their experiences, their symptoms can be helped by identifying and changing their beliefs
What is the process of CBT for schizophrenia?
Agendas between therapist an patient more flexible for schizophrenia, normally 12-20 sessions, cognitive and behavioural element
What is the cognitive element of the CBT process for schizophrenia?
Make patients aware of the role of cognitions and how this impacts functioning, then question, challenge and try to change patient’s beliefs
What is the behavioural element of the CBT process for schizophrenia?
Test patient’s beliefs against reality through experimentation, role play and homework, allow patient to become aware of the irrationality of their beliefs
What is an example of CBT? Who is this influenced by?
Rational Emotive Behavioural Therapy (REBT) which is based on Ellis’ ABC model: activating event pinpointed ans subsequent consequences, belief which is cause of C is discussed, therapist gets patient to understand that their beliefs are illogical (pros/cons of maladaptive ideas)
What is the role of gaol setting in CBT?
realistic goal discussed early in sessions, distressing consequences as motivation for change, therapist must make goals measurable and achievable, revisited at start/end of therapy
What is the role of gaol setting in CBT?
realistic goal discussed early in sessions, distressing consequences as motivation for change, therapist must make goals measurable and achievable, revisited at start/end of therapy
What is the role of the normalisation technique in CBT?
Help to show that some delusional fears are rooted in the normal, empathising with patient, delusion can be maintained but in a more realistic form
What is the role of the decatastrophising technique in CBT?
educating patient that many people can have unusual experiences in a range of circumstances - reduces anxiety and sense of isolation, psychotic experiences placed on a continuum with normal ones, possibility of recovery seems less distant
How is trust developed in CBT? What can happen after this trust is developed?
Being non judgemental, therapist uses gentle questioning to appreciate their illogical deductions, therapist must remain empathetic and open minded
What is the role of developing alternative explanations in CBT?
important that patient develops own alternatives to previous maladaptive assumptions, preferably coping strategies/idea already present in patient or from earlier ideas (from leaflet/discussion) in the therapy
According to Cohen what is a small, medium and large effect size?
0.2 = small, 0.5 = medium, 0.8+ = larger
According to Cohen what is a small, medium and large effect size?
0.2 = small, 0.5 = medium, 0.8+ = larger
Who conducted a review on CBT using a repeated measures design?
Rector and Beck 2001: pre vs post CBT, effect size = 1.23 improvements in all symptoms but spontaneous remission could influence results, possible cherry picking
Who conducted a meta analysis on CBT using an independent groups design?
Gould 2001: RCTs, control and treatment conditions, effect size: 0.65 but no comparison to another treatment
Who conducted a Cochrane review into CBT and other psychosocial treatments?
Jones 2012: RCTs, 20 trials (small, low quality), no difference between CBT and other talking therapies, relapses/re hospitalisation not reduced, no difference if left study early or continued, some long term advantage in dealing with emotions
What is the advantage of CBT over drugs and psychoanalysis?
side effects unlikely, CBT more collaborative so no dependence on therapist like in psychoanalysis
Do patients want CBT?
Tend to like CBT, trials tend to have lower attrition than drugs/talking therapies
Do patients want CBT?
Tend to like CBT, trials tend to have lower attrition than drugs/talking therapies
Should CBT remain as the only talking therapy available on the NHS?
Yes: cheaper than other therapies, doesn’t take as long, helps with independence. No: individual differences may mean other therapies would be better for others, would require more training if other therapies offered
