psychological therapy for schizophrenia

Question 1

what is cognitive behavioural therapy?

Answer 1

a method for treating mental disorders based on both cognitive and behavioural techniques. from the cognitive viewpoint the therapy aims to deal with thinking, such as challenging negative thoughts. the therapy includes behavioural techniques

Question 2

how long is a CBT course usually?

Answer 2

•8-10 weeks
•NICE suggests 16 sessions

Question 3

flow diagram of what CBT aims to challenge

Answer 3

faulty thinking/ irrational thoughts ->
harmful emotions ->
negative behaviours

Question 4

how does cognitive behavioural therapy help schizophrenia patients?

Answer 4

•schizophrenic patients develop belief systems to make sense of the world (delusions)
•they challenge the faulty thinking and help them understand how they lead to delusions and hallucinations
•if a therapist can convince them that the auditory hallucinations (voices) actually coke from malfunctioning speech centres and cannot hurt them, they become less frightening and debilitating
•this reduces stress
•they also use a technique called normalisation where they teach that voice-hearing is an extension of the ordinary experience of thinking in words

Question 5

what does Beck’s model entail?

Answer 5

•patient as scientist
•identify the negative triad (thoughts about the world, self and future)
•challenges thoughts by testing the reality of their negative beliefs, producing evidence to see if the clients statements are correct and

Question 6

what does Ellis’ model entail?

Answer 6

•disputes and challenges irrational thoughts
•empirical disputing and logical disputing

Question 7

what is empirical disputing?

Answer 7

challenging whether there is evidence for the thoughts

Question 8

what is logical disputing?

Answer 8

involves disputing whether the negative thought logically follows from the facts

Question 9

evaluation points for CBT

Answer 9

+cheaper in the long run
+effective- Jauhar
- it’s not a cure as it doesn’t address the underlying causality

Question 10

+cheaper in the long run

Answer 10

•it usually costs less money than prescribing drugs and can see improvements in a shorter amount of time

Question 11

+effective- Jauhar

Answer 11

•meta analysis on 34 studies using CBT with schizophrenia, there is clear evidence for a small but significant effect on both positive and negative symptoms
•supports the benefit of CBT for schizophrenia

Question 12

-it is not a cure as it doesn’t address the underlying causality

Answer 12

•it’s not the challenge that has ‘cured’ them, it’s the validation and positive regard (as well as having rapport with someone, a therapeutic alliance)

Question 13

what are the 3 characteristics of the family systems theory?

Answer 13

•schizophrenogenic mother
•double-bind theory
•high expressed emotion

Question 14

what is family therapy?

Answer 14

a psychological therapy carried out with all of some members of a family with the aim of improving the communications within the family and reducing the stress of living with a family

Question 15

who identified strategies therapists use within family therapy?

Answer 15

Pharoah

Question 16

what was Pharoah’s family therapy?

Answer 16

•forming a therapeutic alliance with all family members
•reducing the stress of caring for a relative with schizophrenia
•improving the ability of the family to anticipate and solve problems
•reduction of anger and guilt in family members
•helping family members achieve a balance between caring for the individual and maintaining their own lives
•improving families beliefs about and behaviour towards schizophrenia
- rest bite is important to reduced HEE

Question 17

what are the two main ways family therapy helps?

Answer 17

•reduces negative emotions (high expressed emotions)
•improves the family’s ability to help

Question 18

what was Burbach’s 7 step programme?

Answer 18

1. sharing basic information and providing emotional/ practical support
2. identifying resources and what people can/ cannot offer
3. aims to encourage mutual understanding, creating a safe space
4. identifying unhelpful patterns of interaction
5. skills training like learning stress management techniques
6. relapse prevention planning
7. maintenance for the future

Question 19

evaluation points for family therapy

Answer 19

+ effective- McFarlane
+ benefits the whole family
+economic benefits

Question 20

+effective

Answer 20

•McFarlane concluded through a meta analysis that it was consistently effective and relapse rates were found to reduce by 50-60%
•showing that family therapy is beneficial and effective

Question 21

+benefits the whole family

Answer 21

•Lobban (and Barrowclough) concluded that it being beneficial for everyone are important because families provide the bulk of care for people with schizophrenia
•strengthens the support system
•it has wider positive impacts beyond just the identified patient

Question 22

+economic benefits

Answer 22

•family therapy reduces relapse rates and makes families better able to provide the bulk of care, meaning they are less likely to use government resources