Psychological therapy for schizophrenia Flashcards
What is CBT?
Psychological therapy
Cognitive behaviour therapy
Takes place over 5-20 sessions
In groups or individually
Aims to deal with both thoughts and behaviour
How does CBT help?
Psychological therapy
Help client make snes of how irrational cognitions impact on their feelings and behaviour
Does not eliminate symptoms but can make it easier for people to cope with them
This will then reduce distress and improves ability to function adequately
What is normalisation?
Psychological therapy
E.g. people hearing voices can be helped by teahcing them that voice-hearing is an extension of the ordinary expericne of thinking in words
Evidence of effectiveness (CBT)
Psychological therapy
Strength
Jauhar et al (2014) reviewed 34 studies using CBT with SZ, concluding there is evidence for small but significant effects on + and - symptoms.
Pontillo et al (2016) found reductions in frequency and severity of auditory hallucinations
Clincal advice from NICE (2019), recommends CBT for SZ
Therefore, both research and clinical experience support benefits of CBT for SZ
Quality of evidence (CBT)
Psychological therapy
Limitation
Thomas (2015) points out that different studies have involved the use of different CBT techniques and people with different combos of + and - symptoms.
Overall benefits of CBT for SZ conceal wide variety of effects of different CBT techniques of different symptoms
Therefore, hard to say how effective CBT will be for a particular person with SZ
Does CBT cure?
Psychological therapy
CBT improves quality of life for people with SZ but doesn’t atcually cure them
SZ appears to be a biological condition so CBT benefits people by improving ability to live with SZ
However, studies report significant reductions in severity of both + and - symptoms
Suggests CBT does more than ehance coping
What is family therapy?
Takes place with family & identified patient
Aims to improve quality of communicantion and interaction between family members
How does family therapy help?
Pharoah et al (201) identified a range of stratergies that family therapists use to improve functioning of the family:
Psychoeducation
Forming an alliance with relatives who care for the person
Reducing emotional climate within family
Enhancing relatives’ ability to anticipate and solve problems
Reducing expressions of anger and guilt by family members
Maintaining reasonable expectations among family members for patient performance
Encouraging relatives to set appropriate limits whilst maintaining some degree of seperation
Burbach (2018) model for working with families dealing with SZ
Psychological therapy
Begins with sharing basic information and providing emotional and practical support
Develops through progessively deeper levels
Phase 2 involves identifying resources including what diff family members can and cannot offer
Phase 3 aims to encourgae mutual understanding, creating safe space for all family members to express their feelings
Phase 4 involves identifying unhelpful patterns of interaction
Phase 5 is about skills training such as learning stress managemnt techniques
Phase 6 looks at relapse prevention planning
Phase 7 is maintenance for the future
Evidence of effectiveness (Family therapy)
Psychological therapy
Strength
McFarlane (2016) concluded family therapy was one of most consistently effectiveness treatments avaliable for SZ
Relapse rates reduced by 50-60%
Also concluded using family therapy as mental health initially starts declining is particularly promising
Clinical advice from NICE recommeds family therapy for everyone with a diagnosis of SZ
Therefore, family therapy is likely to benefit people with early and ‘full-blown’ SZ
Benefits to whole family
Psychological therapy
Strength
Therapy is for the benefit of everyone involved.
Lobban & Barrowclough (2016) concluded these effects are important because families provide bulk of care for people with SZ
By strengthening the functioning of a whole family, family therapy lessens the neg impact of SZ on oher family members
Therefore, family therapy has wider benefits beyond the obvious pos impact on identified patient
Which matters most? (Family therapy)
Because family therapy reduces relapse rates nad makes families better able to provide bulk of care it has huge economic benefits - State does not need to pay so much
However, family therapy also has very significant therapeutic benefits for people with SZ and their families
