Psychological Therapies For Schizophrenia: CBT

Question 1

What is CBTp?

Answer 1

Cognitive Behavioural Therapy for psychosis - a structured talking therapy for schizophrenia. Usually takes place for between 5-20 sessions, either in groups or individually.

Question 2

What is the basic assumption of CBTp?

Answer 2

That people with schizophrenia often have distorted beliefs, which influence feelings and behaviour in negative ways (e.g. delusions).

Question 3

What is the aim of CBTp?

Answer 3

To help the patient to identify and correct the faulty interpretations that cause delusions and make links between their cognition, emotions and behaviours & their symptoms.

Question 4

What are the 3 ways to change irrational cognitions?

Answer 4

Normalisation
Understanding where the delusions/hallucinations come from
Reality testing

Question 5

What is normalisation in CBTp?

Answer 5

Telling the patient that their experiences are an extension of normal functioning - no need to feel ashamed or stressed about them.

Question 6

What is reality testing?

Answer 6

A process in which the patient can demonstrate for themselves that their irrational thoughts aren’t real (e.g. if a patient thinks they can see into the future, the therapist may ask them to predict the cards drawn from a deck)

Question 7

What is a limitation of CBTp? (Premature treatment cancellation)

Answer 7

CBTp requires a big commitment and lots of motivation over a long period of time — this can be difficult for someone suffering with schizophrenia — leads to lots of people giving up on CBTp — not suitable

Question 8

What is a limitation of CBTp? (Waiting times)

Answer 8

On the NHS, waiting list is as long as 2-3 years — not everybody can afford private therapy — unequal access to support

Question 9

What is a strength of CBTp? (Supporting evidence)

Answer 9

Tarrier (2005) - reviewed 20 controlled trials of CBT using 739 patients - found consistent evidence that CBT reduces persistent positive symptoms in chronic patients