Psychological therapy Flashcards
Outline Beck’s goals/steps for CBT.
Cognitive element: Initial assessment
Cognitive element: Identify automatic thoughts about self, world and future – the negative triad
Cognitive element: Goal setting – The patient will be encouraged to test the validity of their negative thoughts
Behaviour element: set homework, to challenge and test their irrational thoughts
Review at next meeting to move forward
Outline CBT for treating schizophrenia.
Normalisation
People hearing voices can be helped by teaching them that voice hearing is an extension of the ordinary experience of thinking
Understanding irrational cognitions
The therapist can help the patient to understand the voices they hear (auditory hallucinations) are from an area of the brain not working properly (Broca’s area)
Challenge delusions
Reality testing is used where the therapist and patient examine the likelihood that their beliefs are true
This leads to alternative explanations
Outline the aims of family therapy for treating schizophrenia.
Improves family’s ability to help: Aim to understand their own beliefs about their role with the identified patient.
Reduces negative emotions: Aim is to reduce the levels of expressed emotion (EE) e.g. guilt and anger which can cause stress.
Outline the steps of family therapy.
Share basic information and provide emotional and practical support
Identify how family members can support the identified patient
Encourage mutual understanding
Identify unhelpful patterns of interaction
Skills training e.g. stress management
Relapse prevention planning
Maintenance for the future
What are the strengths for psychological therapy?
+ Research support: Sameer Juahar et al(2014) reviewed 34 studies of using CBT to treat schizophrenia, concluding that there was small but significant effects on both positive and negative schizophrenia symptoms. NICE also recommends CBT for treatment for schizophrenia. Suggests both research and clinical experience support the benefits of CBT for schizophrenia.
+Possible alternative for medication. There is the debate over whether medication is always appropriate for those with schizophrenia or with mental illnesses at all. There are possible risks and side effects for taking medications, as well as a trial and error period for most people starting on medication. Therapy does not have these risks, and aims to alter the cognitive element of schizophrenia, (hopefully permanently) altering the patients way of thinking making it more preferred.
What are the limitations for psychological therapy as treatment for schizophrenia?
- Quality of evidence: CBT methods and schizophrenia symptoms vary widely. The overall modest benefits of CBT for schizophrenia probably conceal a wide variety of effects of different CBT techniques on different symptoms. This means that it is hard to say how effective CBT will be for a particular person with schizophrenia.
- CBT may improve the quality of life for those with schizophrenia but not ‘cure’ them. Reduces symptoms, good for coping with the condition but perhaps not for completely overcoming it. Additionally, research suggests that a combination of CBT and medication is better than CBT or medication on its own. Suggests CBT could be an inadequate treatment on its own for a condition such as schizophrenia.
