Psychological therapy for schizophrenia

Question 1

Cognitive behavioural therapy (CBT)

Answer 1

• Helps client make sense of how their irrational cognitions impact on their feelings and behaviour
• Understanding where their symptoms come from can be helpful for those with symptoms like auditory hallucinations - e.g if a therapist can convince them that the voice comes from a malfunctioning speech centre in their brain and that it cannot hurt them if they ignore it, it will become a lot less scary
• It will not eliminate their symptoms but it will help them cope with them
• Delusions can also be challenged

Question 2

Family therapy

Answer 2

• Therapy carried out with family members with the aim of improving communications and reducing stress within a family
• Offered as a period of between 3 and 12 months and at least 10 sessions - aimed at reducing level of expressed emotion
• Relapse rate with FT = 25% - compared to relapse rate without FT = 50%
• How does it work?:
  1) Psychoeducation - helping person and their carers to understand and be able to deal with SZ
  2) Ensure family members achieve a balance between caring for the individual with SZ and maintaining their own lives
• During sessions, individual with SZ is encouraged to talk to their family and explain what support they need and find helpful

Question 3

CBT - evaluation - strength

Answer 3

• Evidence for its effectiveness
• Research has found that using CBT for SZ has a small but significant effect on positive and negative symptoms
• Other studies have found reductions in frequency and severity of auditory hallucinations
• Means CBT can benefit SZ

Question 4

CBT - evaluation - limitation

Answer 4

• Wide range of techniques and symptoms included in studies
• Techniques and symptoms vary from case to case
• Different studies have used different techniques with different combinations of positive and negative symptoms
• The small benefits of CBT for SZ probably hide a wide variety of effects of different CBT techniques on different symptoms

Question 5

Family therapy - evaluation - strength

Answer 5

• Benefits to family members
• Researchers analysed the results from 50 family therapy studies - 60% of these studies reported a significant positive impact on at least one outcome category for relatives e.g relationship quality
• Means family therapy has wider benefits beyond the positive impact on the individual with SZ

Question 6

Family therapy - evaluation - limitation

Answer 6

• Methodological issues
• Meta-analyses identified the problem with random allocation - a large number of studies were from China- evidence has emerged that in many Chinese studies, random allocation had not been used (when they had stated it had been used)
• In some studies the researcher wasn’t ‘blinded’ to the condition which increases possibility of researcher bias