psychological therapy for schizophrenia: CBT

Question 1

how is CBT to treat people with schizophrenia?

Answer 1

• commonly used
• takes place over 5-20 sessions, which is longer than for other conditions
• either in groups or an individual basis

Question 2

how does CBT help?

Answer 2

• client can make sense of how their irrational cognitions impact their feelings and behaviour
• understanding where symptoms come from can make them less frightening so less debilitating
• doesn’t elimiate symptoms, but helps people to cope with them
• this reduces their distress and improves their ability to function adequately

Question 3

what is normalisation in CBT?

Answer 3

• understanding that some symptoms are an extension of ordinary experience
• eg. voice-hearing is extension of thinking in words

Question 4

what is reality testing in CBT?

Answer 4

person with schizophrenia and therapist jointly examine likelihood that delusions are true

Question 5

what happens if delusions are resistant to reality testing?

Answer 5

CBT can still be used to tackle the anxiety and depression that result from living with schizophrenia

Question 6

evaluation: evidence for effectiveness (jauhar et al. 2014)

Answer 6

• reviewed 34 studies of using CBT with schizophrenia
• clear evidence for small but significant effects on both positive and negative symptoms

Question 7

evaluation: evidence for effectiveness (pontillo et al. 2016)

Answer 7

reductions in frequency and severity of auditory hallucinations

Question 8

evaluation: clinical advice (NICE 2019)

Answer 8

recommends CBT for schizophrenia

Question 9

evaluation: wide range of techniques and symptoms included in studies (thomas 2015)

Answer 9

• different studies involve use of different CBT techniques and people with different combinations of positive and negative symptoms
• overall modest benefits of CBT for schizophrenia probably conceal a wide variety of effects of different CBT techniques on different symptoms
• difficult to say how effective CBT will be for a particular person
• lowers internal validity of research

Question 10

evaluation: CBT doesn’t cure

Answer 10

• schizophrenia appears to be a largely biological condition
• psychological therapy like CBT only benefits people by improving their ability to live with the condition
• still reduces severity of symptoms so useful