Psychological therapies for schizophrenia

Question 1

What are the 3 psychological therapies?

Answer 1

CBT
Family Therapy
Token economy

Question 2

How does CBT treat schizophrenia?

Answer 2

• Aims to identify and challenge irrational thinking and beliefs, including the delusions and hallucinations of schizophrenia.
• It helps by showing patients how their delusions and hallucinations affect their feelings and behaviours.
• Won’t get rid of symptoms but it can make patients better able to cope with them.

Question 3

How does family therapy treat schizophrenia?

Answer 3

• Aims to improve quality of communication and interaction between family members.
• Reduces stress of living as a family.

Question 4

Who identified a range of strategies by which family therapists aim to improve the functioning of a family with a member suffering from schizophrenia?

Answer 4

Pharoah et al.

Question 5

What strategies did Pharoah propose?

Answer 5

• reducing the stress of caring for a relative with schizophrenia
• reducing anger and guilt of family members
• help family members achieve balance between caring for the individual with schizophrenia and maintaining their own lives

Question 6

What did the strategies of family therapy aim to do?

Answer 6

• Strategies work by reducing the levels of stress and expressed emotion, whilst increasing the chance of patients complying with medication.
• Tends to result in the reduced likelihood of relapse.

Question 7

How does token economy treat schizophrenia?

Answer 7

• Rewards system used to manage the behaviour of patients with schizophrenia.
• In particular those who have developed patterns of maladaptive behaviour through spending long periods in psychiatric hospitals.
• Modifying bad habits doesn’t cure schizophrenia but it improves the patients quality of life and makes it more likely that they can live outside a hospital setting.
• Tokens given immediately to patients when they have carried out a desirable behaviour.
• Tokens can then be later exchanged for more tangible rewards.
• Tokens are secondary reinforcers because they have value once the patients has learned that they can be used to obtain rewards.

Question 8

State a positive of psychological therapies.

Answer 8

Evidence for effectiveness:

• CBT: Jauhar reviewed the results of 34 studies of CBT for schizophrenia and concluded that CBT had a significant but small effect on positive and negative symptoms
• Family therapy: reduces hospital readmission over the course of a year and improves quality of life for patients and family.
• Token economy: only 1 of 3 studies showed improvement in symptoms and none yielded useful information on behaviour change.

Question 9

State 2 negatives of psychological therapies.

Answer 9

Treatments improve quality of life but don’t cure:
- CBT: helps by allowing patents to make sense of and in some cases challenge symptoms
- family therapy: reduces stress of living with schizophrenia
- token economy: helps by making patients behaviour more socially acceptable so they can better re-integreate back into society
Ethical issues:
- token economy - less severe patients have a better chance of displaying desirable behaviour and gaining tokens so more severely ill patients suffer from discrimination