psychological treatments for schizophrenia evaluation

Question 1

evidence for effectiveness

Answer 1

POINT: there is some support for the benefits of psychological treatment for schizophrenia

EVIDENCE: Sameer Jaher et al reviewed the result of studies of CBT for schizophrenia

EXPLANATION: it was concluded that CBT has a significant but fairly small effect on both positive and negative symptoms

Question 2

a study that proves the effectiveness of family therapy

Answer 2

Pharoah et al reviewed the evidence for the effectiveness of family therapy of people with schizophrenia and concluded:

-moderate evidence to show that family therapy significantly reduces hospital readmissions over the course of a year and improves the quality of life for individuals

HOWEVER, they also noted that the results of different studies were inconsistent and there were problems with the quality of some evidence. Overall then, the evidence for family therapy is fairly weak

Question 3

a study that proves the effectiveness of token economies

Answer 3

McMangle and Sultanna (2009) found three studies where people with schizophrenia have been randomly allocated to conditions. This equals a total of only 110 patients

random allocation is important in controlling extraneous variables. Only one of the three studies showed improvement in symptoms and none yielded useful info about behavioural change

therefore overall, there is modest support for the effectiveness of psychological therapies and schizophrenia still remains a difficult mental health problem to treat

Question 4

treatments improve quality of life but do not cure

Answer 4

POINT:
all psychological treatments for schizophrenia discussed have aim to make schizophrenia more manageable and some have improved the individual’s quality of life

EVIDENCE:
CBT allows a person to make sense/ challenge some of these symptoms
Family therapy helps reduce the stress of living with schizophrenia for both family members and sufferers

EXPLANATION:
these things are all worth doing but should not be confused with treating schizophrenia. Biological treatments do not cure schizophrenia either but they do reduce the severity of some symptoms. Failure to cure schizophrenia is a weakness of psychological treatments.

Question 5

ethical issues

Answer 5

POINT: There are no serious side effects/ medical risks of drug treatments but they do raise ethical issues

EVIDENCE: Token economies have been proved to be controversial
The major issue is that privileges, services, e.t.c become more available to patients with mild symptoms and less for those with more severe symptoms of schizophrenia that prevent them from complying with desirable behaviours

EXPLANATION: this means that severely ill patients suffer discrimination in addition to other symptoms

IMPACT: this has resulted in the reduction of token economies as families of patients challenged the legality of this.

Question 6

quality of the evidence for the effectiveness counterpoint

Answer 6

POINT:
many small scale studies in which mental health professionals have compared patients before and after psychological treatments and have found more positive results than those described prior

COUNTERPOINT:
however, these studies have problems e.g. the lack of a control group or if there is one, patients are not randomly allocated to treatment and control conditions

EXPLANATION:
therefore conclusions are generally more optimistic than those with strict control
The other way round is that reviews with tight control may be too pessimistic in their conclusions

IMPACT:
This suggests that psychological treatments may be more effective for some individuals than others because of individual differences. Therefore maybe an idiographic approach to determine which therapy is suitable rather than a “one size fits all” approach to treatment may be better