Psychological therapy Flashcards
What is cognitive behaviour therapy (CBT)?
CBT
- Method for treating mental disorders based on cognitive and behavioural techniques
- Aims to deal with thoughts and behaviour
How is CBT carried out?
CBT
- Takes place over a period of 5-20 sessions (16 average)
- In groups on an individual basis
How does CBT help schizophrenia patients?
CBT
- Helps make sense of how irrational cognitions impact their feelings/behaviour
- Does not eliminate symptoms, but makes people better able to cope- reduces distress and improves ability to function adequately
What is normalisation?
CBT
- I.e hearing voices can be helped by teaching people that it is an extension of the ordinary experience of thinking in words
What is critical collaborative analysis?
CBT
- Individual learns to question illogical deductions about their experiences
What is the ABC model?
CBT
- Ellis- Activating event> behaviour> consequence
- CBT aims to rationalsie, dispute and challenge irrational beliefs
What is an example of CBT in practice?
CBT
- E.g: clients who hear voices and believe these voices represent demonic forces will be naturally afraid
- If therapists can convince them the voice comes from the malfunctioning speech centre in their brain and that it cannot hurt them if they ignore it, it becomes less frightening and less deliberating
What is reality testing?
CBT
- Used to challenge delusions
- The individual and the therapist examine the likelihood that their beliefs are true
- If delusions are resistant to reality testing, CBT can still tackle anxiety and depression that result from living with schizophrenia
What is a case study example of CBT for schizophrenia?
CBT
- Turkington et al- CBT to challnge patients delusions
- Patient believes mafia are trying to kill them, so therapist uses CBT to challenge this belief
Strength-
I- Evidence for effectiveness
CBT
D- Jauhar et al reviwed 34 studies, using CBT for schizophrenia, and concluded there is clear evidence for small, but significant effects on positive and negative symptoms. Pontillo et al found reductions in frequency and severity of auditory hallucinations. NICE recommends CBT for schizophrenia
E- Means both research and clinical experience support CBT benefits
Limitation-
I- Quality of evidence
CBT
D- CBT techniques and schizophrenia symptoms vary widely between cases. Thomas suggests different studies involve the use of different CBT techniques and people with different combinations of positive and negative symptoms. Overall modest benefits may conceal a wide variety of effects
E- Makes it hard to say how effective CBT will be for particular people
Evaluation extra-
I- Does CBT cure?
D- CBT improves quality of life, but does not cure patients. Schizophrenia= biological condition, CBT= psychological treatment, so improves ability to live with condition. E.g: CBT may enhance ability to ignore auditory hallucinations, so experience less anxiety, but this does not eliminate symptoms. However, studies report significant reduction in symptom severity, suggesting CBT does more than enhance coping
E- Means CBT may only be a partial cure
What is family therapy?
Family therapy
- Therapy carried out with members of the family and the identified patient (a member of the family who expresses the family’s conflicts)
- Aim of improving communications and interaction within the family
How does family therapy work?
Family therapy
- Pharoah et al identified a range of strategies that family therapists use to improve functioning of families with schizophrenic members
- Reduces negative symptoms, improves family’s ability to help
How long does family therapy last?
Family therapy
- 3-12 months
- Minimum 10 sessions
What are the strategies used in family therapy?
Family therapy
- Psychoeducation (understand/deal with illness)
- Forming an alliance with relatives
- Reducing emotional climate and burden of care
- Enhancing relatives’ ability to anticipate/solve problems
- Reducing expressions of guilt/anger
- Maintaining reasonable expectations for patient performance
- Encouraging relatives to set appropriate limits, whilst maintaining some degree of separation
How does family therapy reduce negative symptoms?
Family therapy
- Reduces levels of expressed emotion (negative emotions that cause stress, i.e. anger/guilt)
How does family therapy improve the family’s ability to help?
Family therapy
- Therapist encourages family members to form a therapeutic alliance (agree on aims of therapy)
- Tries to improve families’ beliefs about/behaviour towards schizophrenia
- Ensures family members achieve a balance between caring for the schizophrenic member, and maintaining their own lives
What is the model of practice?
Family therapy
- Burbach proposed a model for working with families dealing with schizophrenia
What are the 7 phases of the model of practice?
Family therapy
1- Sharing basic information, and providing emotional and practical support- develops through deeper levels
2- Identifying resources, including what members can/cannot offer
3- Aims to encourage mutual understanding, creating a safe space for members to express their feelings
4- Identifying unhelpful patterns of interaction
5- Skills training (i.e. stress management)
6- Relapse prevention
7- Maintenance for the future
Strength-
I- Evidence for effectiveness
Family therapy
D- McFarlane concluded that family therapy was one of the most consistently effective schizophrenia treatments. Relapse rates were reduced by 50-60%. Using family therapy as mental health starts to declien is particularly promising. NICE recommends family therapy for all with a schizophrenia diagnosis
E- Means it is likely to benefit people with both early and ‘full-blown’ schizophrenia
Strength-
I- Benefits the whole family
Family therapy
D- Therapy does not only benefit the individual, but their families too. Lobban and Barrowclough concluded effects are important as families provide the bulk of care for the schizophrenic patient. By strengthening family functioning, therapy lessens the negative impact of schizophrenia on other family members, and strengthens the ability of the family to support the patient
E- Means family therapy has wider benefits beyond the individual
Evaluation extra-
I- What matters most?
Family therapy
I- As family therapy reduces relapse rates and makes families better able to provide the bulk of care, it has huge economic benefits. The state does not need to pay so much for hospital care, benefits, etc. However, family therapy also has therapeutic benefits for patients and their family
E- Suggests everyone wins, as therapy benefits both the individual and their families
