Psychological Treatment of Schizophrenia

Question 1

Psychological Treatment for SZ

Answer 1

• Most popular psychological approaches to treat SZ are CBT and family therapy

CBT => to treat dysfunctional thought processing
Family therapy => to treat family dysfunction

• these therapies should be used alongside antipsychotics

Question 2

Cognitive Behavioural Therapy (CBT)

Answer 2

Method for treating mental health disorders based on cognitive + behavioural therapies

• Cognitive => Thinking : therapy aims to challenge negative/irrational thoughts
• Behavioral => deliberate behaviours to test reality of thought

Question 3

How CBT helps

Answer 3

• Over 5-20 sessions + helps patients
  => understand how irrational delusions / halluncinations impact their feelings + behaviour

=> understand source of symptoms (can be helpful e.g. auditory hallucinations less scary when due to malfunctions not “demons”

=> improve ability to function adequately

=> normalise symptoms + challenge irrational thoughts

Question 4

Family Therapy

Answer 4

Psychological therapy w/ all/some members of family with SZ to improve communication + reduce stress in home

Pharoah et al (2010)
- reduces negative emotions: aims to reduce levels of EE => stress => relapse
- improves family’s ability to help - therapist encourages family agree on aims of therapy + improve beliefs about SZ
- help achieve balance for family between care + maintaining own lives

Question 5

The model of practice for Family Therapy - Barbach (2018)

Answer 5

1) share basic info - provide emotional + practical support
2) identify resources for family / what they can + or can’t offer patient w/ SZ
3) encourage mutual understanding + safe space to express feelings
4) identify unhelpful patterns of interaction
5) build skills + train stress management
6) relapse prevention planning
7) maintenance for future

Question 6

(S) Evidence for CBT’s Effectiveness - Jaubar et al (2014)

Answer 6

• Reviewed 34 studies using CBT - evidence for small but significant effects on positive + negative symptoms
• NICE (2017) recommends use of CBT for SZ

Demonstrates => both research + clinical experiences support benefits for CBT

Question 7

(L) Evidence for CBT is of low quality - Thomas (2015)

Answer 7

• Both techniques used in CBT - a person’s specific symptoms will vary
• If CBT works for 1 patient - that form may not be applicable to another if symptoms differ

Demonstrates => effectiveness for CBT is hard to generalise w/ all SZ sufferers

Question 8

(S) Evidence for Family Therapy’s Effectiveness - McFarlane (2016)

Answer 8

• Review showed FT as 1 of most consistently effective treatments available for SZ - relapse reduced by 50-60%
• NICE (2017) recommends use of FT to everyone w/ a SZ diagnoses

Means => family therapy may be beneficial

Question 9

(S) Benefits all family members - Labbar + Barrowlough (2016)

Answer 9

• Important as families provide most of care for SZ patients
• Lessens negative impact on other family members + strengthens abillity to support patients

Means => family therapy has wider benefits beyond just the patient