Psychological therapies Sz

Question 1

Aim of CBT?

Answer 1

Identify and challenge irrational thoughts- e.g. through a discussion about how true a patient’s beliefs are. Does not rid a patient of symptoms but reduces them

Question 2

How does CBT link to Sz?

Answer 2

Patients can be helped to understand the nature of their hallucinations and delusions and how they impacts feelings and behaviour

Question 3

What feeling can CBT reduce?

Answer 3

Anxiety- e.g. if a person thinks voices in their head come from the devil, ask how do you know that is the Devil?

Question 4

What is family therapy?

Answer 4

Aims to improve the quality of interactions and communication within families- links to double bind and Sz mothers e.g. by reducing EEs

Question 5

What are modern therapists more interested in doing? (family therapy)

Answer 5

Reducing family stress and relapse

Question 6

Pharoah strategies?

Answer 6

Form a therapeutic alliance with all family members
Reduce the stress relating to caring for a relative with SZ- healthy balance with own life
Improve a family’s ability to solve problems
Reduce anger and guilt

Question 7

What is a token economy?

Answer 7

Tokens in the form of coloured discs are given to the patient when they have carried out a desirable behaviour that has been targeted for reinforcement- a form of operant conditioning

Question 8

Desirable behaviours?

Answer 8

Making a bed, washing themselves

Question 9

What setting may token economies be used?

Answer 9

Hospitals after a long stay- institutionalisation

Question 10

Why are rewards important?

Answer 10

Reduces delay discounting - where the impact of the reward is reduced

Question 11

What can tokens be exchanged for?

Answer 11

Sweets, cigarettes, magazines or privileges such as a walk outside

Question 12

Jauhar?

Answer 12

Reviewed the results of 34 CBT studies and found that it had a significant but small impact on positive and negative symptoms

Question 13

Eval- Pharoah?

Answer 13

Reduces the hospital readmissions over a year and improves quality of Sz and family life- family therapy- overall evidence for effectiveness however is weak

Question 14

Sultana?

Answer 14

Found that only 3 studies had random allocation to conditions- with only 1 out of 3 demonstrating improvements in positive and negative symptoms- CBT

Question 15

Problem with all treatments?

Answer 15

They treat but do not cure e.g. token economies make behaviour more acceptable

Question 16

Ethical issues with token economies?

Answer 16

The people who receive rewards are often the ones with the less severe conditions- most ill are discriminated against and some families have challenged it legally

Question 17

Ethical issues with CBT?

Answer 17

Does it go too far to challenge free thought e.g. challenge belief about government

Question 18

What is an alternative treatment for Sz?

Answer 18

Art therapy- concerns dealing with negative symptoms such as avolution- should be used alongside medication