Psychological Treatments Flashcards
What 3 psychological treatments do we look at?
How does one differ?
- Cognitive Behavioural therapy (CBT)
- Family therapy
- Token economy - involved in management rather then treatment
What is cognitive behavioural therapy?
Therapy that addresses both the cognitive and behavioural issues of sch simultaneously. Works on the theoretical foundations of the cognitive explanation, that dysfunctional thoughts shape behaviours and emotions. Aim is to help patients to identify their faulty delusionary beliefs and reduce stress associated with symptoms as well as developing more rational constructive ways of thinking, coping and functioning.
What are the two techniques used in CBT?
- Integrated Psychological Therapy (IPT)
- Coping Strategy Enhancement (CSE)
What is Integrated Psychological Therapy?
- Used to improve attention and refine concept formation, this technique tries to identify specific cognitive deficits and treat them in a non-confrontational manner
- For example, clients are taught to recognise and respond appropriately to social cues (to combat avolition and inappropriate affect) and to evaluate verbal statements more accurately (to combat alogia and disorganised thinking)
- This could take place in engaging group exercises that emphasize repetitive training that allow patients to refine new behavioural tactics
- Another step is to challenge faulty interpretations using reality tests to hopefully remove false beliefs
Summarise Chadwick et al (1999)
Reported the case of an individual who believed he could make things happen by simply thinking them. He was shown 50 video clips and asked to say what would happen next. In total he did not get a single prediction correct and was able to understand that he did not have the power to influence events after all
What is Coping Strategy Enhancement?
- Tries to teach patients better ways to manage the severity and frequency of their psychotic symptoms to reduce distress and their impact on day-to-day functioning
- Through a process of education, the patient is taught a range of coping strategies to help manage more intrusive symptoms
- Cognitive strategies can involve distractive thoughts and positive self talk ; whereas behavioural strategies can include relaxation techniques, and ways of drowning out hallucinatory voices
Summarise evaluations for CBT
- Research to support - Startup et al
- CSE research to support - Tarrier
- CBT is an appropriate mechanism to encourage patients to take their antipsychotic medication - Garrett
- Appropriateness - young people assumed to be more suitable
- Not suitable for all symptoms - Zimmerman
Summarise Startup et al
Recruited 90 patients admitted to hospital due to an acute episode of SCH. 43 got standard care of APs and nursing (control group) whist other 47 got standard care plus up to 25 90 minute CBT sessions. They found 60% of the CBT group showed clinical improvement compared to 40% of control group
Summarise Tarrier
Using strategies like distraction, positive self talk, concentrating on specific taskd and relaxation techniques. Tarrier et al found 73% of their sample reported they were successful at managing their symptoms
Summarise Zimmerman
Found there does seem to be a place for CBT helping with the auditory and visual hallucinations that sufferers experience and it particularly helps in reducing distress and negative emotions experienced by individuals who suffer these hallucinations. However it may be less helpful in treating some of the negative symptoms of the disorder.
What is Family Therapy ?
This type of therapy is based on social as well as psychodynamic issues surrounding the dysfunctional backgrounds that patients suffering with schizophrenia may originate from. The therapy is aimed at helping the patient and their families development constructive practical coping skills to minimalist the chances of relapse. It can often take up to and over 20 sessions
What are the five stages of family therapy?
- developing co-operative and trusting relationships
- psycho education
- given set of practical coping skills
- taught to express concern
- trained to recognise early signs of relapse
Summarise evaluations of family therapy
- evidence to support effectiveness - Leff
- methodological issues - cannot establish cause and effect
- can be damaging for families - not receptive to therapy or feel blame
- despite high costs, reduces revolving door syndrome
- support from other cultural research - Xiong et al
Summarise Leff et al (1982)
Found that families engaging in family therapy showed a significant decrease in critical comments directed to the patient and reduced over involvement (features of HEE). 14% of patients in this group had relapse compared to 78% of group who did not receive it
Summarise Xiong et al (1994)
Randomly allocated 63 Chinese patients with schizophrenia to either drug treatment or drug treatment with family therapy. They found 61% of drug treatment only group had relapsed compared to 36% of the drug treatment and family therapy group
