Psychological therapies for schizophrenia

Question 1

Define CBT, family therapies and token economies.

Answer 1

CBT- A method of treating mental disorders, like schizophrenia, by using behavioural and cognitive techniques. In terms of cognitive techniques, the focus is on improving thinking ie) challenging negative thoughts. Behavioural techniques are also used.

Family therapies- A form of psychological therapy where all/some members of the family gather and the focus is to improve overall communication and relationships between all the members.

Token economies- A form of behavioural therapy focused around selective reinforcement, providing tokens as secondary reinforcers to rewards desirable behaviours. These tokens can then be traded for primary reinforcers ie) food/privileges.

Question 2

Explain CBT

Answer 2

• commonly used to treat schizophrenia
• 5-20 sessions as a group/individual
• Focus=on identifying and challenging irrational thoughts and providing less threatening alternatives
• doesn’t treat schizophrenia, just reduces symptoms

How it helps= makes sense of emotions caused by delusions and hallucinations, reduces anxiety, ie) Case of Turkington et al.

Question 3

Explain Family Therapy

Answer 3

• aims to improve quality or communication and interaction b/w family members
• concerned w/ reducing family stress that contributes to relapse, specifically reducing levels of Expressed Emotion (EE)

How it helps (Acc. to Pharoah et al)= forms alliance b/w members, reduces stress for caring for a patient, reduces anger and guilt towards patient, improves understanding of schizophrenia etc. This reduces relapse and re admission rates.

Question 4

Explain Token Economies

Answer 4

• manages behaviour of patients who are institutionalised to maladaptive behaviour due to psychiatric hospitals.
• improves quality of patients life

How it helps= tokens create reinforced behaviour, but need to be immediately rewarded to prevent delayed discounting. This uses operant conditioning.

Question 5

What is the AO3 for psychological therapies?

Answer 5

Ethical issues (with token economies and more severely ill schizophrenics)
Alternative psychological treatments- NICE recommends art therapy
Improves quality of life, but doesn't cure
Evidence for effectiveness- Jauhar (CBT), Pharoah (family therapy), McMongale and Sultana (token economies and random allocation)
Quality of evidence for effectiveness- lack of control group, lack of random allocation and are too optimistic in conclusions