Psychological Therapy For Schizophrenia Flashcards
How is CBT used to treat Sz?
- 5-20 sessions and aims to deal with thoughts and behaviour
- makes sense of how irrational cognitions (hallucinations) impacts behaviour, understanding where symptoms come from can be helpful as it makes them less frightening and so less debilitating - wont eliminate symptoms but will allow patient to cope
- Could be taught auditory hallucination are an extension of ordinary experience (normalisation)
- delusions can be challenged by reality testing in which the likelihood that beliefs are true is examined. Some cases where delusions are resistant to reality testing CBT can be used to tackle anxiety and depression
What is Family Therapy?
- takes place with patients family as well as the identified patient (one member of a dysfunctional family who expresses the family’s conflicts), improves quality of communication/interaction
How does family therapy help?
Pharoah identified strategies:
- Reduces Negative Emotions: reduce levels of expressed emotion (EE) especially negative one e.g anger which create stress (important to reduce likelihood of relapse)
- Improves family ability to help: Therapist encourages family members to form a therapeutic alliance where they all agree on aims of therapy. Therapist tries to improve families beliefs/behaviours towards Sz. Also to ensure family members achieve balance between caring for patient and maintaining own life
What is a model of practice for Family Therapy?
- Burbach et al proposed a model for working with families dealing with Sz.
- Phase 1: Sharing basic info and providing emotional and practical support, develops through progressively deeper levels
- Phase 2: identifying resources including what different family memebers can offer
- Phase 3: encourages mutual understanding, safe space for all family members to express feelings
- Phase 4: identifying unhelpful patterns of interaction
- Phase 5: skills training e.g stress management
- Phase 6: relapse prevention an planning
- Phase 7 future maintenance
- What is evidence for effectiveness CBT?
- Jauhar 34 studies using CBT with Sz evidence for small but significant effects on both positive and negative symptoms
What is the issue regarding the quality of evidence for CBT for Sz
- Thomas points out different studies use different CBT techniques and different combos of positive and negative symptoms
- evidence is inconsistent
What is evidence for effectiveness family therapy?
- McFarlane concluded family therapy was one of the most consistently effective treatments available for Sz
- relapse rates were reduced by 50-60%
- NICE recommend it for anyone with Sz diagnosis
What is a further strength of family therapy outside the patient?
- it also is helpful for the families that provide the bulk of care for patients, lessens the negative impact of Sz on other family members and strengthen ability of family to support patient, therefore economically is less of a burden on organisations such as the NHS
