Psychological Therapy - A03

Question 1

Evidence of effectiveness (CBT)

Answer 1

P) One strength of CBT for schizophrenia is the evidence for its effectiveness.
E) Sameer Jauhar et al. (2014) reviewed 34 studies of using CBT with schizophrenia, concluding that there is clear evidence for small but significant effects on both positive and negative symptoms.
E) Other studies have focused on symptoms, for example Maria Pontillo et al. (2016) found reductions in frequency and severity of auditory hallucinations. Clinical advice from NICE (2019), the National Institute for Health and Care Excellence, recommends CBT for schizophrenia.
L) This means that both research and clinical experience support the benefits of CBT for
schizophrenia.

Question 2

Quality of evidence (CBT)

Answer 2

One limitation of CBT for schizophrenia is the wide range of techniques and symptoms included in studies.
CBT techniques and schizophrenia symptoms vary widely from one case to another.
Neil Thomas (2015) points out that different studies have involved the use of different CBT techniques and people with different combinations of positive and negative symptoms. The overall modest benefits of CBT for schizophrenia probably conceal a wide variety of effects of different CBT techniques on different symptoms.
This makes it hard to say how effective CBT will be for a particular person with schizophrenia.

Question 3

Evidence of effectiveness (family therapy)

Answer 3

One strength of family therapy for schizophrenia is evidence of its effectiveness.
A review of studies by William McFarlane (2016) concluded that family therapy was one of the most consistently effective treatments available for schizophrenia. In particular relapse rates were found to be reduced, typically by 50-60%. McFarlane also concluded that using family therapy as mental health initially starts to decline is particularly promising. Clinical advice from NICE recommends family therapy for everyone with a diagnosis of schizophrenia.
This means that family therapy is likely to be of benefit to people with both early and ‘full-blown’ schizophrenia.

Question 4

Benefits to whole family ( family therapy )

Answer 4

A further strength of family therapy for schizophrenia is the benefits for all family members.
Therapy is not just for the benefit of the identified patient but also for the families that provide the bulk of care. A review of evidence by Fiona Lobban and Christine Barrowclough
(2016) concluded that these effects are important because families provide the bulk of care for people with schizophrenia. By strengthening the functioning of a whole family, family therapy lessens the negative impact of schizophrenia on other family members and strengthens the ability of the family to support the person with schizophrenia.
This means that family therapy has wider benefits beyond the obvious positive impact on the identified patient.