Psychological Therapy For Schizophrenia Flashcards
How is cognitive behavioural therapy used for schizophrenia patients?
- Is commonly used to treat people with schizophrenia. It usually takes place over a period of 5-20 sessions- either in groups or on an individual basis
- CBT aims to deal with both thoughts (cognition & behaviour)
How can cognitive behaviour therapy help patients w schizophrenia?
- CBT can help a client make sense of how their irrational cognitions (such as delusions & hallucinations) impact on their feelings & behaviour
- Just understanding where symptoms come from can be hugely helpful for those w symptoms like auditory hallucinations
If for example, a client hears voices & believes the voice represents demonic forces they will naturally be very afraid - If therapist can convince them that the voice represents demonic forces, they will naturally be very afraid- if therapist can convince them that the voice naturally comes from the malfunctioning speech centre in their own brain & that it cannot help them if they ignore it, this is much less frightening & hence less disabling.
This will not eliminate symptoms of schiz but it can make people better able to cope w them
What is family therapy?
- Involves the ‘identified patient’ & family members
- Can take a few sessions or a few months
- Therapy aims to improve quality of communication & interaction between family members
How can family therapy help?
Fiona Pharoah et al (2010) identified range of strategies that family therapists use to try improve functioning of family that has a member w schizophrenia:
Reduces negative emotions:
FT aims to reduce levels of expressed emotion i.e reduce the level of emotion generally but especially negative emotions such as anger & guilt which create stress- reducing stress is important to reduce likelihood of relapse
Improves the familys ability to help
Therapist encourages family members to form a theraputic alliance whereby they all agree on aims of therapy
Therapist also tries to improve families beliefs about & behaviour towards schizophrenia
- A further aim is to ensure family members achieve a balance between caring for the individual w schiz & maintaining their own lives
What is the model of practice within schizophrenia?
Franch Burbach (2018)
- Proposed a model for working families dealing w schizophrenia
1. Begins w sharing basic info & providing emotional & practical support- then it develops to progressively deeper levels
2. Involves identifying resources including what different family members can & cannot offer
3. Phase 3 aims to encourage mutual understanding, creating safe space for all family members to express feelings
4. Involves identifying unhelpful patterns of interaction
5. Is all about skills training such as learning stress management techniques
6. Phase 6 looks at relapse prevention planning
7. Is maintenance for the future
Give an evaluation point for CBT.
- CBT may improve quality of life for people w schiz but not actually ‘cure them’.
- As schiz appears to be a largely biological condition we wld expect a psychological therapy like CBT just benefits people by improving their ability to live w schizophrenia
On other hand…
- Studies report significant reductions in severity of both positive & negative symptoms
Suggesting that CBT does more than enhance coping
Give one strength of CBT.
- The evidence for its effectiveness
- Sameer Jauhar et al (2014) reviewed 34 studies using CBT w schizophrenia
- Concluded that there is small but significant effects on both positive & negative symptoms
This research further supports the benefits of CBT for schizophrenia
Give one strength of family therapy in schizophrenia.
- Evidence of effectiveness
- Review of studies by William McFarlane (2016) concluded that family therapy was one of the most consistently effective treatments avaliable for schiz
- Relapse rates were found to be reduced typically by 50-60%
- McFarlane also concluded that using family therapy as mental health initially starts to decline is particularly promising.
- Clinical advice from NICE recommends family therapy for everyone w a diagnosis of schiz
This means that family therapy is likely to be of benefit to people w both early & ‘full blown’ schizophrenia
Give another benefit to family therapy.
- There are benefits for all the family members
- Therapy is not just for benefit of identified patient, but also for families that provide bulk of care
- Researchers concluded these effects are important because families provide the bulk of care for people w schiz
- By strengthening functioning for whole family, family therapy lessens negative impact of schiz on other family members & strengthens ability of family to support person w schiz
This means family therapy has wider benefits beyond obvious positive impact on identified patient
