Psychological Treatments for schizophrenia Flashcards
1
Q
what are the 3 treatments (don’t need to talk about all 3 in 16 marker)
A
- CBT
- Family Therapy
- Token Economies
2
Q
what is the AO1 for CBT
A
- CBT aims to help patients with Sz by changing their maladaptive thinking and distorted perceptions in order to modify hallucinations and delusional beliefs.
- Antipsychotic drugs are usually given first to reduce psychotic thought processes, so that CBT can be more effective.
- CBT is then undertaken around once every 10 days, for about 12 sessions, to identify and alter irrational thinking.
- Drawings are often used to display links between sufferers’ thoughts, actions and emotions. Understanding where symptoms originate from can be useful in reducing sufferers’ anxiety levels.
3
Q
What is the AO1 for PT (personal therapy)
A
- One CBT approach is personal therapy (PT), involving detailed evaluation of problems and experiences, their triggers and consequences, and strategies being used to cope. → won’t be able to describe triggers if in episode - drugs are key
Techniques used in PT are: - Distractions from intrusive thoughts
- Challenging the meanings of intrusive thoughts
- Increasing/decreasing social activity to distract low moods
- Using relaxation strategies
- PT is also used to tackle problems faced by schizophrenics discharged from hospital, taking place in small groups or as a one-to-one therapy.
- Patients are taught to recognise small signs of relapse, which can build up to produce cognitive distortions and unsuitable social behaviour. → try to educate the patient
4
Q
what is the +ve AO3 point for CBT as a treatment for schizophrenia
A
- Research Support: Tarrier (2000)
- found that people with schizophrenia receiving 20 sessions of PT coupled with drug therapy did better than sufferers receiving drug therapy alone or supportive counselling with drug therapy.
- 1/3 of patients receiving CBT achieved a 50% reduction in psychotic experiences, with 15% free of all positive symptoms, compared to 15% reduction in psychotic experiences in the counselling group, with 7% free of all positive symptoms.
- No patients in the drugs-only group were symptom-free.
- Combination works, however is that the interactionist approach, CBT is cognitive
5
Q
what are the -ve AO3 points for CBT as a treatment for schizophrenia
A
- Lack of support- Jauhar et al
- Further issues to consider
6
Q
expand on the -ve AO3 point, Lack of support- Jauhar et al, for CBT as a treatment for schizophrenia
A
- performed a meta-analysis of 50 studies of CBT for schizophrenia conducted over the last 20 years
- found only a small therapeutic effect on symptoms, including positive symptoms, such as delusions and hallucinations, which CBT mainly targets.
- Even this small effect disappeared when only studies using blind testing (where researchers are not aware which patients have received CBT) were considered.
- This strongly questions whether CBT should be used as a treatment for schizophrenia.
7
Q
expand on the -ve AO3 point, Further issues to consider, for CBT as a treatment for schizophrenia
A
- For CBT to be effective, success is dependent on developing empathy, respect, and honesty between patient and practitioner.
- This was supported by Rathod et al (2005) finding that non-Afro-Caribbean therapists had less success using CBT with Afro-Caribbean patients than white patients, as empathy between such clinicians and patients was harder to establish. → people prefer counsellors that are in there in group than out group
- CBT is not suitable for all patients, especially those too disorientated, agitated or paranoid to form trusting alliances with practitioners. → also dangerous + unsafe for the practitioner
8
Q
what is the AO1 for family therapy
A
- Family therapy is based on the idea that as family dysfunction can play a role in the development of schizophrenia, altering relationship and communication patterns within dysfunctional families and lowering levels of expressed emotion should help schizophrenics recover.
- Therefore, the treatment involves the whole family, not just the member with schizophrenia, with the family becoming the patient’s support network.
- Therapists meet regularly over 9-12 months with the patient and family members, who are encouraged to talk openly about the patient’s symptoms, behaviour and progress with their treatment and how the patient’s illness affects them. → therapist is like a mediator
- Family members are taught to support each other
- There is an overall emphasis on ‘openness’, with no details remaining confidential → have to talk openly otherwise it doesn’t work
9
Q
what are the aims of family therapy
A
- The main aims of family therapy are: (trying to lower the levels of expressed emotion, and reduce the behaviours that cause schizophrenia)
- Improve positive and decrease negative forms of communication.
- Increase tolerance levels and decrease criticism between family members.
- Decrease feelings of guilt and responsibility for causing the illness among family members.
10
Q
what are the +ve AO3 points for family therapy as a treatment for schizophrenia
A
- Research Support
- The Schizophrenia Commission
11
Q
expand on the +ve AO3 point, research support, for family therapy as a treatment for schizophrenia
A
- Leff et al (1985) compared family therapy with routine outpatient care for schizophrenics with families high in expressed emotion
- In the first nine months of treatment 50% of those receiving routine care relapsed compared with 8% of those receiving family therapy.
- Pilling et al (2002) performed a meta-analysis of several forms of psychological treatment for schizophrenia, including 18 studies of family therapy with 1,467 patients
- family therapy had the smallest number of patients who relapsed and the lowest number of hospital readmissions
- These studies suggest family therapy is an effective form of treatment. + is obviously very important treatment for young patients still living at home with family
12
Q
expand on the +ve AO3 point, The Schizophrenia Commission, for family therapy as a treatment for schizophrenia
A
The Schizophrenia Commission (2012) estimates that family therapy is cheaper than standard care by £1,004 per patient over three years, suggesting it is a relatively cost-effective treatment. → stops relapse - less hospital admissions - less stress on resources + workers
13
Q
what is the -ve AO3 point for family therapy as a treatment for schizophrenia
A
- With the emphasis on ‘openness’ there can be an issue with family members being reluctant to share sensitive information, as it may cause or reopen family tensions.
- Openness of ALL family members is key in effective treatment.
- Some members may have suppressed things that they don’t want to bring up → however openness is key
14
Q
what is the AO1 for token economies
A
- behaviourist therapeutic approach based on principles of operant conditioning and reinforcement where tokens are awarded for demonstrations of desired behavioural change. → reinforcing the desired behaviour
- mainly used with long-term hospitalised patients to enable them to leave hospital and live relatively independently within the community.
- Token economies are particularly aimed at changing negative symptoms of schizophrenia, such as low motivation, poor attention and social withdrawal.
- With Sz it is really important that the reward is IMMEDIATE after the patient demonstrates the behavioural change.
- The tokens can then be exchanged for goods or privileges.
- Desired behaviour can be things like examples of self-care, adherence to medication regime and social interaction.
15
Q
what are the +ve AO3 points for token economies as a treatment for schizophrenia
A
- Research Support
- Positive Effects of Token Economies in therapeutic settings
