psychological therapy

Question 1

Cognitive behvaioural therapy

Answer 1

-teach client to identify irrational thoughts+challenge them via an argument and discussion in 5 to 20 sessions.
-this helps patient to make sense of their thoughts+sympos+showing them that their symps r unlikely to be true
-it lowers anxiety but doesnt irradicate their symps of delusions, paranoia +hallucinations
-normalisation= teaching them that voice hearing=extension of ordinary experience of thinking words
-delusions r challenged by reality testing
-one form is personal therapy: looks at detailing problems, experineces, triggers+consequences+stratergies to cope

Question 2

cbt research
turkington et al (2004)

Answer 2

• describe an example of cbt used to challenge where a paranoid clients delusions come from
• PC: the mafia r watching me to decide how to kill me
• T: u r obvs v frightened.. there myst be a gd reason for this
• PC: do u think its the mafia?
• T:its a possibility, but there could be other expl, how do u know that its the mafia?

Question 3

family therapy

Answer 3

-improves quality of communication+interaction between members
-lowers stress in families to stop a relapse+decreases expressed emotions
-helps w theories like the double blind n sz mother

Question 4

fiona pharoah et al 2010

Answer 4

-identified range of stratergies that family therapists use to try to improve functioning of family that has a member w sz
-FT reduces negative emotions: aims to reduce levels of expressed emotion, n all negative emotions esp anger n guilt which creates stress
-reduce stress=important to reduce likelihood of relapse
-imporves familys ability to help: therapist encourages members to form a therapeutic alliance where they all agree on aims of therapy. they also try to improve the fams beliefs about n behaviour to sz. also ensure family members have a balkance between carying n mainting own lives

Question 5

ft

model of practice

Answer 5

-burbach 2018. 7phases of ft
-1: share basic info+provide emotional+practical support
-2: identifying resources incl what diff family members can/cannot offer
-3: aims to encourage mutual understanding, create safe space for all family members to express their feelings
-4: involves identifying unhelpful patterns of interaction
-5: skills training such as learning stress management tech
-6: relapse preventing planning
-7: maintance for the future

Question 6

a03

evidence for effectiveness

Answer 6

-jauhar et al (2014): review 34 cbt studies n found theres evidence for small but significant effects on positive n negative symptoms
-pontillio et al 2016: found reductions in frequecny n severity of auditory hallucinations.
-clinical evidence form NICE (2019) recommends cbt for sz
=gd validity n reliability

Question 7

ao3 cbt

lack of availability

Answer 7

-despite it being recommended in NICE study its estimated as little as 1 in 10 acc get access to this therapy
-haddock et al (2013) found that of 187 randomly selected sz only 13 had been offered cbt n those who were many failed to attend/refused thus limiting effectiveness
-also requires trained pro to dleiver the sessions over number of months making it incredibly costle +time consuming
-they make struggle to open up/build connection w therapist= effectiveness largely influenced by skill of therapist
-WHEREAS drugs=cheap, no time, easy to administer

Question 8

ao3

questioned effectiveness of cbt altogether

Answer 8

-meta analyses into cbt tend to reach unreliable conclusions on its effectiveness due to poor methodology+setup
-eg ppts werent always randomly allocated between cbt group or control group
-interviewers often aware of treatment conditions further biasing results
-juni et al (2001): clear evidence that problems associated w methodologically weak trials translated into biased findings about effectiveness of cbt itself
-wykes 2008 found more rigorous a study was=weaker benefits of cbt
=uneffective

Question 9

ao3 ft

benefit whole fam
lobban+barrowclough 2016

Answer 9

-therapy not j for sz patient but also families that provide bulk of care
-they concluded these effects=important bc fams provide bulk of care for ppl w sz by strengthening functioning of whole family
-it lessens negative impact of sz w other family members+strengthens the ability of family to support person w sz

Question 10

ao3 ft

nature v nurture

Answer 10

-garety et al 2008: conducted a study into effectiveness of FT + this failed to show any improved outcome for patients w ft compared to patients who had carers but no ft
-both had significantly lower relapse rates compared to no carers at all
-study also found most of carers displayed low rates of expressed emtoion which may refelct knowledge+attitude change to sz as disorder.
-but he believed for most ppl ft didnt improve outcomes beyond recieving gd standard of treatment as usual
-its a psychological treatment+assumes ‘nurture’ can override potential bio problem caused by ‘nature’=this may make ft inappropriate
-eg ppl w sz likely have bio cause+treat w ft may simply paper cracks to manage symps .so ft does nothing to address underlying problem thats causing sz making it ineffective