psychological therapies for schizophrenia Flashcards

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1
Q

what are the 3 types of psychological therapies for schizophrenia

A
  1. CBT
  2. Family therapy
  3. token economy
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2
Q

how many sessions of CBT and group size

A

usually 5-20 sessions
groups or individual

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3
Q

what’s the aim of CBT for schiz

A

helping patients identify irrational thoughts n trying to change them.
may involve discussion how likely patients bleifies r to be true and consideration of less threatening possibilities.

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4
Q

does CBT get rid of SChiz

A

no helps patients better able to cope with symptoms

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5
Q

how does CBT help delusions n hallucinations

A

helps make sense of delusions n halluncinations, impacts on feelings n behaviour. understanding where symptoms come from hugely helpful.

e.g. hears voices-thinks demon=afriad. this can help reduce this anxiety.

delusions challenged so patient comes to learn beliefs not based on reality.

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6
Q

who gave a case example of CBT

A

Tarkington et al 2004

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7
Q

what was the case study example for CBT

A

paranoid patient: the mafia r observing me to decide how to kill me
therapist: you r obviously very frightened.. there must be a reason for this.
paranoid patient: do u think its the mafia?
therapist: its a possibility, but there could be other explanations. How do u know its the mafia?

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8
Q

what’s family therapies aim?

A

improve quality of communication between family members.

double-bind and schizogenic mother some psychologist see as root cause.
now more concerned w reducing stress (expressed emotion)

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9
Q

what are Pharaoh et al 2010 range of strategies family therapy uses to improve

A

-forming a therapeutic alliance with all family members
-reducing stress of caring for relatives w schiz.
-improving abilities to anticipate and solve problems.
-reducing anger n guilt in family members
-helping families achieve balance between caring for the individual with schiz and maintaining their own lives.
-improving families beliefs abt and behaviour towards schiz

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10
Q

how do these stratergies work according to Pharaoh

A

reducing levels of stress and expressed emotion, whilst increasing chances of patient complying with medication.
combination of benefits result in reduced likelihood of relapse and re-admission to hospital.

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11
Q

what is a token economies

A

reward system used to manage beh of patients w schiz, in particular those w maladaptive beh.

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12
Q

token economy- what’s maladaptive behaviour involve

A

spend long periods of time in institutions (psychiatric hospitals)
under these conditions often-bad hygiene, remianing in pyjammers all day.
modifying this beh doesn’t cure but improves quality of life, more likely to live outside hospital.

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13
Q

what an example of token

A

example- coloured disks immediately given to patients after carrying out desirable behaviour targeted for reinforcement.

may be getting dressed in the morning, making the bed, according to particular patient beh issues.

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14
Q

token- why is the immediacy of rewards important

A

it prevents ‘delay discounting’= reduced effect of delayed reward.

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15
Q

what can tokens be swapped for

A

tangible rewards
e.g. sweets, cigarettes or magazines or forms of service-having room cleaned or privileges like walk outside the hospital

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16
Q

token economies is based on what

A

operant conditioning, tokens are secondary reinforcers.

^because they have more value once patient learns they can be used to obtain rewards

17
Q

evaluation of psychological therapies for schizophrenia

A

-evidence for effectiveness
-treatments improve quality of life but do not cure
-ethical issues

18
Q

what evidence for effectiveness is there

A

Jauhar et al 2014-CBT
Pharaoh et al-family therapy
McMonagle and Sultana 2009-token economy

19
Q

what was Jauher et al research

A

reviewed results of 34 studies of CBT for schiz.
concluded: CBT has significant but fairly small effect on both positive and negative symptoms.

20
Q

what was Pharoah et al research

A

reviewed evidence for effectiveness of family therapy for schiz sufferers. concluded-there is moderate evidence to show that fam therapy significantly reduces hospital readmission over course of YR. n improves quality of life for patients n family.
However results of different studies were inconsistent + problems w quality of evidence.
overall research family therapy weak

21
Q

what was McMonagle and sultana research into token economy

A

reviewed evidence for token economy.
found only 3 studies where patients had been randomly allocated to conditions. total of 110 patients.
random allocation is important in matching patients to treatment and control groups.
only 1 of 3 studies showed improvements in symptoms + none had useful infomationabt beh change.

22
Q

what’s the overall point to evidence for effectiveness

A

there is only modest support for the effectiveness of psychological treatments and schiz remains one of the harder mental health problems to treat.
limitation of psychological treatments.

23
Q

treatments improve quality of life but do not cure

A

all psychological treatments are a way to make schiz more manageable n improve quality of life.
-CBT
-family therapy
-token economy
but all don’t cure. failure to cue is weakness

24
Q

ethical problems - token economy

A

token economy- privileges services. become more available to mild symptom patients, those more severe less-this prevents them complying with desirable behaviour.

means-most severely ill face discrimination, some families of patients challenged legality of this. in turn reduced use of token economy in psychiatric system.

25
Q

ethical issues - CBT

A

CBT challenges persons paranoia but at what point do this interfere w persons freedom of thought.

example- belief in controlling government, can easily stray into modifying their politics

weakness of treatments