Psychological Therapies for Schizophrenia Flashcards
What are the psychological therapies for Schizophrenia?
CBT, Family therapy, Token economies
What is CBT?
Takes place between 5 and 20 sessions. The aim is to help patients identify irrational thoughts and change them. It doesn’t get rid of the symptoms of schizophrenia but it helps them cope better with them.
How does CBT help?
Patients can be helped to make sense of how their delusions and hallucinations impact their feelings and behaviour. Offering psychological explanations for the existence of hallucinations and delusions can help reduce this anxiety. Delusions can also be challenged so that they can understand they are not reality.
What is Family Therapy?
Its is carried out with all or some members of a family with the aim of improving their communication and reducing the stress of living as a family. Explanations such as double bind and the schizophrenogenic mother suggest that the family is cause.
FT aims to reduce levels of EE
How does family therapy help?
Fiona Pharoah identified a range of strategies used to improve the functioning of a family with a member suffering from schizophrenia:
- forming a therapeutic alliance with all family members
- improving the ability of the family to anticipate and solve problems
- reduction of anger and guilt in families
- helping them find a balance between caring and their own lives
These work by reducing stress and EE whilst increasing patients chances of complying with medication.
What is token economies?
A method where desirable behaviour are encouraged by the use of selective reinforcement e.g when a patient engages in correct/socially desirable behaviours they are given a token, which can later be exchanged for rewards.
How do token economies work?
The token is an immediate symbol of reward and increases the effect of reinforcement as opposed to a delayed reward.
The therapy is based on operant conditioning and the tokens are secondary reinforcers whilst the rewards ate primary reinforcers.
What is the evaluation for psychological therapies for schizophrenia?
Evidence for effectiveness
Improve quality of life but don’t cure
Ethical issues
Alternative psychological treatments
Evaluation point for psychological therapies for schizophrenia: Evidence for effectiveness
Juahar: reviewed the results of 34 CBT studies for schizophrenia - concluded CBT has a significant effect on positive and negative symptoms.
Pharoah: reviewed family therapy effectivity - found that it significantly reduces hospital readmission over the course of a year and improves family quality of life.
McMonagle: Found only 1 in 3 studies showed improvement in symptoms and behaviour change.
Only modest support for effectiveness.
Evaluation point for psychological therapies for schizophrenia: Improve quality of life but don’t cure
All the psychological treatments aim to make schizophrenia more manageable and improve quality of life.
CBT helps make sense and challenge symptoms.
FT helps reduce stress of living with schizophrenia in a family.
TE help make patients’ behaviour more socially acceptable so they can re-integrate into society.
None actually cure schizophrenia = weakness.
Evaluation point for psychological therapies for schizophrenia: Ethical issues
TE in particular is controversial, rewards are more available to patients with mild symptoms than those with more severe symptoms that prevent them from complying with desirable behaviours. Therefore severely ill patients experience discrimination.
CBT challenges paranoia, but this arguably interferes with an individuals freedom of thought.
Evaluation point for psychological therapies for schizophrenia: Alternative psychological treatments
Are other psychological therapies that can be helpful that are less well-known and less available. NICE recommends art therapy. This is a strength as there is a wide variety of psychological treatments therefore if one doesn’t help they can try another.
