Psychological therapy for schizophrenia Flashcards
The aim of CBT
To help clients identify irrational thoughts e.g delusions and hallucinations, and try to change them
Helps find coping mechanisms, doesn’t get rid of the symptoms
5-20 sessions, individually or in a group
CBT helps clients understand their symptoms
Clients are helped to make sense of how their delusions and hallucinations impact on their feelings and behaviour
For example a client may hear voices and believe they are demons so they will be very afraid
Normalisation involves explaining to the client that hearing voices is an ordinary experience
Case example for CBT
Turkington et al treated paranoid client who believed the Mafia were plotting to kill him
The therapist acknowledged the client’s anxiety, and explained that there were other, less frightening possibilities and gently challenged the client’s evidence for his belief in the Mafia explanation
Two strengths of CBT
Research support
Quality of evidence
EVALUATION: Research support (CBT)
- explain Point and Evidence
P - There is research support for the role of CBT as a long term treatment of schizophrenia
E - According to the NICE study, cognitive behavioural therapy (CBT) was found to be more effective than antipsychotic medication in lowering the rate of relapse and returning to the hospital up to 18 months after treatment.
EVALUATION: Research support (CBT) -> Issues and Debates
Additionally, CBT adopts a more idiographic approach to treatment, with the therapist taking into account the distinct viewpoints of each patient, which is often seen as a strength because the patient is valued as an individual. This stands in stark contrast to biological treatments, which take a nomothetic approach and assume that all patients should respond to the same treatments since they see the cause of schizophrenia as biological.
EVALUATION: Research support (CBT) -> Counterpoint
However many studies that examine CBT typically examine it when it is used in conjunction with other (biological therapies). Consequently, it is difficult to separate the effects of CBT and biological treatments and such findings should be treated with caution
L - As a result, although while evidence supports CBT’s roleas a specific effective treatment for schizophrenia, these findings need to be consideredcautiously because other factors, such as drugs, may also be enhancing CBT’s effectiveness as a psychological treatment for schizophrenia.
One limitation of CBT
Quality of evidence
EVALUATION: Quality of evidence (CBT)
P - One limitation of CBT is the quality of evidence
E - Thomas points out that different studies have focused on different CBT techniques and people with different symptoms
E - Overall modest benefits of CBT for schizophrenia may conceal a range of effects of different techniques on different symptoms
L - This means that it is hard to say how effective CBT will be for treating a particular person with schizophrenia
EVALUATION ExTrA: Does CBT cure?
CBT may improve quality of life but not ‘cure’ it. As schizophrenia is a biological condition CBT should only improve ability to live with schizophrenia
But studies report significant reductions in positive and negative symptoms. This suggests CBT does more than enhance coping
On balance then it may well be that CBT may be a partial cure for schizophrenia
Family therapy aim
To reduce levels of expressed emotion, especially negative emotions such as anger and guilt which creates stress
Reducing stress is important to reduce the likelihood of relapse
The role of the therapist in family therapy
Encourages family members to form a therapeutic alliance whereby they all agree on the aims of therapy
The therapist also tries to improve families’ beliefs about and behaviour towards schizophrenia
Further aim -> ensure that family members achieve a balance between caring for the individual with schizophrenia and maintaining their own lives
The phases of Bubach’s model
Phases 1-2 - share info and identify resources family can offer
Phases 3-4 - learn mutual understanding and look at unhelpful patterns of interaction
Phases 5,6 and 7 - skills training (e.g stress management techniques), relapse prevention and maitenance
How family therapy helps -Fiona Pharoah et al (2010) identified a range of strategies to improve functioning of a family with a member suffering from schizophrenia…
- Forming a therapeutic alliance with all family members.
- Reduction of anger and guilt in family members.
- Reducing stress of caring for someone with schizophrenia.
- Help families maintain a balance between caring for the individual with schizophrenia and maintaining their own lives.
She suggested that these strategies work by reducing stress levels and expressed emotion whilst increasing the chances of patients’ complying with medication .So this leads to reduced likelihood of relapse and readmission to hospital.
Two strengths of family therapy
Evidence of its effectiveness
Benefits for the whole family
