Psychological Treatments for Schizophrenia Flashcards
What is the main psychological treatment for schizophrenia?
(CBT)
CBT.
It’s how they think about things that causes the problem, not the problem itself that causes the issue.
The aim of CBT is to help schizophrenia to change/ challenge maladaptive thinking and distorted perceptions, seen as underpinning the disorder in order to modify hallucinations and delusional beliefs.
This may involve a discussion on how likely the patients belief is likely to be true, and consideration of other less threatening possibilities.
How does CBT see schizophrenia?
Beliefs, expectations and cognitive assessment of self, the environment and nature of personal problems affects how the individuals perceive themselves and others, how they are approached, and how successful people are in coping and reaching goals.
It’s how they think about things that causes the problem, not the problem itself that causes the issue.
What is the aim of CBT in schizophrenia?
The aim of CBT is to help schizophrenia to change/ challenge maladaptive thinking and distorted perceptions, seen as underpinning the disorder in order to modify hallucinations and delusional beliefs.
This may involve a discussion on how likely the patients belief is likely to be true, and consideration of other less threatening possibilities.
How CBT helps schizophrenics?
Helps the patient make sense of how their delusions and hallucinations impact on their feeling and behaviour.
This understanding is helpful, and helps to reduce anxiety.
Delusions can also be challenged so that the patients learns that their beliefs are not based on reality. For example, if a patient hears voices and believes the voices are demons, they will naturally be very afraid. Offering psychological explanations for the existence of hallucinations and delusions can help reduce anxiety.
Anti-psychotics drugs are usually given first to reduce psychotic thought process, so that CBT can be more effective. CBT once every day 10 days for about 12 sessions (each 1 hour).
Drawings are often used to show the links between thoughts, actions and emotions. Understanding where symptoms originate from is useful at reducing anxiety.
What is personal therapy?
A CBT approach that involves detailed evaluation of problems and experiences, their triggers and consequences, and strategies used to cope.
CBT techniques are developed between patient and therapist. State these techniques.
Challenging the meaning of intrusive thoughts.
Distractions from intrusive thoughts.
Increases/ decreases of social activity to distract from a low mood.
Using relaxation techniques.
Outline Tarrier et al’s study from 2000.
(Supports the use of personal therapy (CBT) and drug therapy, over lone drug therapy or counselling)
(AO3 Research for Personal Therapy)
Supports the use of personal therapy (CBT) and drug therapy, over lone drug therapy or counselling.
This is because they found that people with schizophrenia receiving 20 sessions of PT in 10 weeks, coupled with drug therapy, followed by four booster sessions during the next year, did better than patients receiving drug therapy alone or supportive counselling.
1/3 of patients receiving PT achieved a 50% reduction in psychotic experiences, with 15% free of all positive symptoms, compared with 15% in the counselling group, with 7% free of all positive symptoms.
No patients in the drugs-only group were symptom-free.
One year later, similar differences still existed, but at a two-year follow-up the PT group’s advantage over the counselling group had vanished, though both groups still outscored the drugs-only group.
What is family therapy?
(Family therapy)
Also known as Focused Therapy.
A form of psychotherapy (treatment of mental health using psychological techniques e.g. talking helps the individual to deal with their disorder) that involves the whole family rather than an individual patient.
Some therapists see family as root cause, however most therapists are more concerned with reducing stress in the family.
What is the aim of family therapy?
(Family therapy)
Aim is to improve the quality of communication and interaction between family members.
What did Pharoah do in 2010?
(Family therapy)
Identified a range of strategies used in FT to help improve the functioning of a family with a member suffering from schizophrenia.
What were Pharoah’s 6 strategies used in FT to help improve the functioning of a family with a member suffering from schizophrenia?
(Family therapy)
Form a therapeutic alliance with all family members.
Reducing the stress of caring for a relative with schizophrenia.
Improving the ability of family to anticipate and solve problems.
Reduction of anger and guilt in the family.
Helping family members to achieve a balance between caring for the individual with schizophrenia and maintaining their own lives.
Improving families’ beliefs about and behaviour towards schizophrenia.
What does a therapist do during family therapy?
(Family therapy)
Therapists meet regularly with patient and family and encourage them to talk openly about all aspects e.g. symptoms, behaviour and progress.
Family are also taught to be supportive of each other and be caregivers. Each family member is also given a specific role in the rehabilitation of patient.
Openness is a key part of therapy with no material remaining confidential.
However, boundaries are set before therapy begins, as this forms part of the informed consent paperwork.
What do Pharoah’s strategies do?
(Family therapy)
Reduce stress and increases the chances of patients’ complying with medication.
This combination results in a reduced likelihood of a relapse.
How long does FT last?
(Family therapy)
A set time period of 9 months to a year.
Outline McFarlane et al’s study from 2003.
(Supports family therapy)
(Family therapy)
Supports family therapy.
This is because they reviewed available evidence to find that family therapy results in reduced relapse rates, symptom reduction in patients and improved relationships among family members.
This resulted in increased well-being for patients.
This suggests that family therapy is an effective treatment, with an indication that better family relationships are the key element.
