psychological therapies for sz

Question 1

there are three main psychological therapies for sz these include

Answer 1

CBT
family therapy
token economy systems

Question 2

CBT involves an initial assessment of the patient by a therapist where the patients symptoms and problems are clarified.
CBT emphasises the importance of understanding, although this treatment cannot

Answer 2

directly ‘cure’ the sz , many patients find it comforting to understand the causes of their symptoms , especially if they are suffering from upsetting hallucinations or delusions

Question 3

this understanding in CBT reassures patients that they are not ‘crazy’ reducing the intrusive effects of their symptoms and increasing their self awareness , as proposed by

Answer 3

Tarkington et al who found that CBT could be used to challenge a patients paranoid beliefs

Question 4

in CBT more effective behaviours are put into place by questioning the reality of the patients beliefs and considering other

Answer 4

more reasonably alternatives

Question 5

family therapy aims to reduce the stress of living together as a family with a schizophrenogenic mother , in particular the levels of

Answer 5

expressed emotions are lowered through improving the families beliefs and attitudes towards schizophrenia , reducing stress , increasing feelings of self efficacy and being trained to look for signs which may precede a sz episode
- Therefore, the stress upon the SZ patient lessens, reducing the likelihood of relapse because they are more likely to be cooperative with medical advice and diligently take their medication.

Question 6

token economy systems are based upon behaviourist principles and are frequently used in psychiatric institutions. Target desirable behaviours are identified by staff and thus every time a behaviour is displayed they are rewarded with a token (acting as a secondary reinforcer) which can then be exchanged for a reward or privilege , therefore patients are motivated by

Answer 6

the primary reinforcer to carry out the desirable behaviours , and their frequency of doing so increases as they are positively reinforced.
Rewards may include extra Tv time , exercise taken outside of the grounds of the hospital and favourite magazines.

Question 7

• none of the three psychological therapies above actually treat the patient and ‘ cure’ their sz instead these therapies simply

Answer 7

improve their quality of life through making the symptoms more manageable. For example, token economies increase the likelihood that the patients act in accordance with hospital rules and breaks disruptive patterns of behaviour, whilst family therapies reduce stress within a schizophrenic family and so increase the likelihood of the patient complying with their medical advice, whereas CBT improves the patient’s understanding of their symptoms. This suggests that an interactionist approach towards treatment is best adopted: biological therapies can treat the distal causes of SZ, whilst psychological therapies can treat the proximal symptoms!

Question 8

• there are serious ethical issues associated with the use of psychological therapies , and specifically concerning token economies , for example some may argue that

Answer 8

the ‘privileges’ that patients receive upon displaying appropriate behaviours are actually rights. Preventing patients from calling home or exercising outside may increase their stress and so aggravate their condition further. In addition, patients with the most severe SZ may find it near impossible to comply with these rules, and so will bear the most negative consequences. Similarly, CBT raises ethical issues because the therapist essentially has control over the patient’s views. This means that by challenging the idea of a Mafia as a controlling government instead, for example, the therapy is infiltrating into the patient’s personal beliefs. These changes can be anything, and not always beneficial.

Question 9

+ there is significant evidence supporting the use of a combination of treatments and the interactions approach to treating sz , as suggested by Tarrier et al

Answer 9

These researchers studied 315 patients who were randomly allocated to one of three conditions, where the last control group received no treatment and the first two groups received a combination of psychological and biological treatments.
The researchers found that, after an 18 month follow-up, “there were significant advantages for CBT and supportive counseling over TAU (treatment as usual) alone on symptom measures at 18 months but no group difference was seen for relapse or re-hospitalisation. Therefore, adjunctive psychological treatments can have a beneficial long-term effect on symptom reduction”.