Psychological therapy for schizophrenia Flashcards
cognitive behavioural therapy
- common treatment
- 5 - 20 sessions
deal with thoughts (cognitions) and behaviour
how cognitive behavioral therapy helps
- help a client make sense of how their irrational cognitions (delusions and hallucinations) impact on their behavior and feelings
- understanding where symptoms come form can be helpful for those with auditory hallucination
- if a therapist can convince a client hat the voices in their head actually comes from the malfunctioning speech centre in there brain and it cannot hurt them if they ignore it, this is less frightening
- redueces distress and improves ability to function adequately
- delusions are challenged by a process of reality testing
family therapy
- families and identified patients
- aims to improve the quality of communication and interactions between members
- in line with psychological theories like the double bind and the schizophrenic mother
how family therapy helps
phero et al (2010) identified a range of strategies that therapists use to improve the functioning of the family
1. reducing negative emotions
- reduces the levels of expressed emotions
- reducing stress reduces the likelihood of relapse
2. improves the family ability to help
- encourages family members to form a therapeutic alliance ehry they a ll agree on the aim of therapy
- therapist improves families beliefs and behavoiur towards schizophrenia
- ensure that family members achieve a balance between caring for the individual and maintaining their own life
a model of proactive
phase 1 - share basic information and provide emotional and practical support
phase 2 identifying resources and family members can and cannot offer
- phase 3 - encourage mental understanding and create a safe space for all family members to express their feelings
phase 4 - identify unhelpful patterns of interaction
phase 5 - skill training eg stress management techniques
phase 6 - relapse prevention
phase 7 - maintenance for the future
strength of family therapy
- evidence of effectiveness
- review of studies by McFarlene (2016) concluded that family therapy was one of the most consistently effective treatment available for schizophrenia
- relapse rates reduced by 50- 60 %
- using family therapy as mental health starts is promising
- NICE recommends family therapy for everyone with a diagnosis of schizophrenia - benefits to the whole family
- review of evidence by Lobban and Barrowclough (2016) concluded that these effects are important because families provide the bulk of care for people with schizophrenia
- by strengthening the functioning of a whole family, family therapy lessens the negative impact of schizophrenia on other family members and strengthens the ability of the family to support the person with schizophrenia
strengths of CBT for schizophrenia
- evidence of effectiveness
- Jauhar et al (2014) reviews 34 studies of using CBT with schizophrenia, concluding that there is evidence for significant effects on positive and negative symptoms
- other studies that focused on symptoms found reductions in frequency and severity of auditory hallucinations
- clinical advice form NICE recommends CBT for schizophrenia
limitations of CBT for schizophrenia
- quality of evidence
- CBT techniques and schizophrenia symptoms vary widely from one case to another
- thomas (2015) points out that different studies involed the use of different CBT techniques and people with different combinations of positive and negative symptoms
- benefits of CBT conceal a wide variety of effects of different techniques on different symptoms
