psychological therapy for SZ

Question 1

Cognitive behaviour therapy CBT

Answer 1

a method for treating mental disorders based on both cognitive and behavioural techniques

Question 2

Family therapy

Answer 2

a psychological therapy carried out with all or some members of a family with the aim of improving the communications within the family and reducing the stress of living as a family

Question 3

CBT

Answer 3

5-20 sessions
Groups or individual basis

Question 4

How CBT helps

Answer 4

CBT can help a client make sense of how their irrational symptoms like delusions impact their feelings and behaviour.

Question 5

example of how CBT helps

Answer 5

just understanding where symptoms come from can be helpful for anyone suffering from hallucinations; it is better for a person to be convinced that the voices come from the malfunctioning speech centre in their own brain rather than demonic forces.

Question 6

what can CBT not do

Answer 6

get rid of any symptoms

Question 7

What can CBT do

Answer 7

allow for the client to better cope with them, reducing their distress and improving their ability to function adequately.

Question 8

normalisation

Answer 8

Hearing voices may also be treated by teaching them that it is an extension of the ordinary experience of thinking in words

Question 9

How can delusions be challenged?

Answer 9

by using reality testing in which the schizophrenic along with the therapist both examine the likelihood that beliefs are true.

Question 10

What else can CBT be used to treat

Answer 10

anxiety and depression, that are a result of living with schizophrenia.

Question 11

A case example

Answer 11

Turkington et al described how CBT was used to challenge where a person’s delusions came from. The delusions were about the mafia trying to kill him but the therapist calmly explained that there may be other explanations.

Question 12

evidence of effectiveness for CBT

strength

Answer 12

• Jauhar et al reviewed 34 studies
• Concluded that clear evidence for small but significant effects on all types of symptoms
• Pontillo et al found reductions in frequency and severity of auditory hallucinations
• Clinical advice from national institute for health and care excellence recommends CBT for SZ
  Both research and clinical evidence supporting the benefits of CBT

Question 13

quality of evidence - wide range od techniques and symptoms included in studies

limitation

Answer 13

• Thomas points out that different studies involve the use of different CBT techniques
• People have varying schizophrenia symptoms
  Hard to say how effective CBT will be for a particular schizophrenic

Question 14

family therapy description

Answer 14

• Takes place with family and identified patient
• Range of approaches
• Keeps in line with double-blind and the schizophrenic mother

Question 15

Pharoah et al

Answer 15

identified a range of strategies od how family therapy helps

Question 16

Reduces negative emotions

how family therapy helps

Answer 16

reduce levels of expressed emotion EE, eg anger and guilt which create stre

Question 17

Improves the families ability to help

how family therapy helps

Answer 17

encourages family members to form a therapeutic alliance, improve families beliefs and behaviour towards SZ, ensure family members achieve a balance of caring for the identified patient and maintaining their own lives

Question 18

Burbach proposed a model for working with families.

Answer 18

• Sharing basin information and providing emotional and practical support
• Identifying resources including what family members can and can’t offer
• Encourages mutual understanding, creating a safe space for all family members to express their feelings
• Identifying unhelpful patterns of interaction
• Skills training such as stress management
• Relapse prevention planning
• Maintenance for the future

Question 19

evidence for effectiveness of family therapy

strength

Answer 19

• McFarlane concluded that family therapy is most effective
• Relapse rates reduced by 50-60%
• Using the therapy as mental health begins to decline is particularly promising
• NICE recommends this for everyone with SZ
  Likely to benefit people with early and full blown schizophrenia

Question 20

benefits to whole family

strength

Answer 20

• Lobban and Barrowclough concluded that these effects are important because families provide the bulk of care
• By strengthening the function of a whole family, family therapy lessens the negative impact of SZ on other family members and strengthened the ability to support
  Wider benefits beyond the obvious