Psychological therapies for sz *

Question 1

Cognitive behavioural therapy

Answer 1

A method for treating mental disorders based on cognitive and behavioural techniques. The aim of CBT involves helping people identify irrational thoughts and trying to change them. This may involve argument or a discussion of how likely the person’s beliefs are to be true, and a consideration of other less threatening possibilities. Offering psychological explanations for the existence of hallucinations and delusions can help reduce patients’ anxiety.

Question 2

Family therapy

Answer 2

takes place with families aims to improve the quality of communication and interaction between family members. Most family therapists are concerned about reducing stress within the family that might contribute to a person’s risk of relapse. IN particular,family therapy aims to reduce levels of expressed emotion.

Question 3

Pharoah et al. identified a range of strategies by which family therapists aim to improve the functioning of a family including…?

Answer 3

therapeutic alliances with all family members
reducing the stress of caring for an individual with sz
reduction of anger and guilt in family members

this reduces the level of stress and expressed emotion

Question 4

token economies

Answer 4

reward system whereby desirable behaviours are encouraged by the use of selective reinforcement. For example, people are given rewards (tokens) as secondary reinforcers when they engage in socially desirable behaviours that has been targeted for reinforcement. The tokens can be exchanged for primary reinforcers - privileges. This form of behavioural therapy is based on operant conditioning

Question 5

AO3: treatments improve quality of life but don’t cure

Answer 5

All the psychological treatments for sz discussed here aim to make sz more manageable and in some way improve individuals’ quality of life. CBT helps by allowing a person to make sense of and in some cases challenge their symptoms. Family therapy helps by reducing the stress of living with sz in a family, both for the person themselves and the other family members. Token economies help by making the individuals’ behaviour more socially acceptable so that they can better re-integrate into society. These things are all worth doing, but should not be confused with curing sz. Even bio treatments do not cure sz either but they do reduce the severity of the symptoms. The failure to cure sz is a weaknessof psychological treatments.

Question 6

AO3: ethical issues

Answer 6

Although psych treatments do not have serious side effects or medical risks of drug treatments, they can raise ethical issues. In particular token economy systems have proved controversial. The major issue is that privileges, services, etc.., become more available to patients with mild symptoms and less so for those with severe symptoms of sz that prevent them complying with desirable behaviours. This means that most severely ill patients suffer discrimination in addition to other symptoms, and some families of patients have challenged the legality of this. This has in turn reduced the use of token economies in the psychiatric system.

Question 7

AO3: family therapy evidence for effectiveness

Answer 7

Pharoah et al reviewed the effectiveness of family therapy for families of people with sz. They concluded that there is moderate evidence to show that family therapy significantly reduces hospital readmission over the course of a year and improves the quality of life for individuals and their families. However,they also noted that results of diff studies were inconsistent and that there were problems with the quality of some evidence. Overall then the evidence base for family therapy is fairly weak.