psychological therapy for schizophrenia Flashcards
(12 cards)
name 2 types of psychological therapy for schizophrenia
- cognitive behaviour therapy (CBT)
- family therapy
how many sessions does CBT normally happen over
5-20 sessions in groups or individual basis
what does CBT aim to deal with
thoughts (cognitions) & behaviour
how does CBT help treat schizophrenia
- help client make sense of how their irrational cognitions (eg. delusions, hallucinations) impact their feelings & behaviour
- understanding where symptoms come from can be helpful for those with symptoms like auditory hallucinations (eg. convince them speech is from malfunctioning speech centre in brain not demonic forces = reduces fear & less debilitating)
- doesn’t eliminate symptoms but helps individuals cope
- individuals hearing voices can be taught that voice-hearing is an extension of the ordinary experience of thinking in words = normalisation
- delusions can be challenged (eg. reality testing)
- if delusions resistant to reality testing, CBT can still be used to tackle anxiety/depression
case example of using CBT to treat schizophrenia
turkington et al. (2004) described example of CBT used to challlenge paranoid client’s delusions:
client: ‘the mafia are observing me to decide how to kill me’
therapist: ‘you are obviously frightened… there must be a good reason for this’
client: ‘do you think it’s the mafia?’
therapist: ‘it’s a possibility, but there could be other explanations. how do you know that it’s the mafia?’
CBT AO3 +) evidence for it’s effectiveness
E:
- jauhar et al. (2014) reviewed 3 studies using CBT with Sz & concluded there’s clear evidence for small but significant effects on both negative/positive symptoms
- pontillo et al. (2016) focused on symptoms & found reductions in frequency/severity of auditory hallucinations
- clinical advice from NICE (2019) recommends CBT for Sz
T: means research & clinical experience support benefits of CBT for Sz
CBT AO3 -) wide range of techniques & symptoms included in studies
E:
- thomas (2015) points out different studies have involved use of different CBT techniques & people with different combinations of positive/negative symptoms
- overall modest benefits of CBT for Sz probably conceal wide variety of effects of different CBT techniques for different symptoms
T: makes it difficult to say how effective CBT will be for particular person with Sz
describe family therapy
- with families & identified patient
- aims to improve quality of communication & interaction between family members
- range of approaches to family therapy for Sz
how does family therapy help
= pharoah et al. (2010) identified range of strategies that family therapists use to try improve functioning of family with Sz member
- reduces negative emotions
- aims to reduce levels of expressed emotion (especially negative emotions which creates stress eg. anger, guilt)
- reducing stress is important as reduces relapse risk - improve family’s ability to help
- therapist encourages family members to form therapeutic alliance where they all agree on therapy aims
- therapist also tries to improve families’ beliefs about/behaviour towards Sz
- another aim is to ensure family members achieve balance between caring for individual with Sz & maintaining their own lives
model of family therapy being put into practice (7 phases)
= burbach (2018) proposed model for working with families dealing with Sz which develops through progressively deeper levels
- phase 1: share basic info & provide emotional/practical support
- phase 2: involves identifying resources (eg. what different family members can/cannot offer)
- phase 3: aims to encourage mutual understanding = creates safe space for all family members to express feelings
- phase 4: identify unhelpful interaction patterns
- phase 5: skills training (eg. learning stress management techniques)
- phase 6: relapse prevention planning
- phase 7: maintenance for the future
family therapy AO3 +) evidence for effectiveness
E:
- mcfarlane (2016) conducted review of studies & concluded family therapy was one of most consistently effective treatments for Sz
- relapse rates found to be reduced (usually 50-60%)
- also concluded that using family therapy as mental health begins to decline is particularly promising
- clinical advice from NICE recommends family therapy for everyone with Sz diagnosis
T: family therapy is likely to benefit those with early & ‘full-blown’ Sz
family therapy AO3 +) benefits whole family
E:
- benefits not just identified patient but also families
- review of evidence by lobban & barrowclough (2016) concluded these effects are important as families provide most of care
- by strengthening function of whole family, family therapy lessens negative effects of Sz on other family members & strengthens ability of family to support person with Sz
T: means family therapy has wider benefits beyond positive impact on identified patient
