Psychological treatments for schizophrenia Flashcards
Cognitive Behavioral Therapy
CBT assumes that schizophrenia is the result of dysfunctional thought processes
-For example, faulty cognitions such as delusions are identified by CBT and ultimately changed
Role of the therapist in CBT
-The role of the therapist is to challenge irrational beliefs
-This could be by arguing the reality of delusions and helping to develop alternatives
Ellis ABC (DE) model
-The ABC model is used to understand the cause of the faulty cognition and cognitively restructure the irrational beliefs (delusions)
Reality testing
-Reality testing is a technique used by therpists in which a patient can demonstrate for themselves that their irrational beliefs (delusions or hallucinations) are not real
-For example asking a patient that believes they can see into the future to predict cards being drawn from a deck
Evaluation point for the effectiveness of CBT (Strength - tested to do better + long term)
-Researchers found that patients were were drug resistant had significant reductions in both positive and negative symptoms after 19 sessions of CBT
-They continued to shoe improvements even 9 months after the treatment had ended
-This suggests that CBT is effective in treating schizophrenia when drug therapies are not
-CBT could also be an improvement to drug therapies as drugs only reduce symptoms short term
Negative evaluation point for the effectiveness of CBT (high dropout rate)
-Ending the treatment early is common due to the length of the process, symptoms may become severe during this time
-CBT requires engagement and negative symptoms may lead to an unwillingness to take part
-Positive symptoms may lead to a distrust of the process
Positive and negative evaluation for CBT
-CBT does not have the severe side effects of certain drug therapies
-This makes it the preferred treatment for many patients
-However, due to the expensive cost of doing multiple sessions with a trained therapist, drug therapy is the most common
Family Therapy
-Family therapy aims to improve the home situation of the person with schizophrenia
-This is because family dysfunction is thought to increase the chance of relapse for recovering schizophrenics
-Family centered therapy aims to change the behaviour of the entire family, rather than just the person with schizophrenia
Psychoeducation
-Psychoeducation is when the family is educated about the symptoms of schizophrenia, so that they are more understanding of their schizophrenic family member’s behaviour
Priorities of family therapy
- Reduce conflicts by addressing anger within the family
- Reduce stress caused by caring responsibilities
3.Reduce self sacrifice by getting the carer to consider their own needs
4.Improve communication by reducing the expression of emotions - Improve problem solving skills by predicting the problems and having solutions ready to deal with them
Research evaluation of family therapy (positive + negative short terms)
Supporting research conducted by Leff (1985) looked into the after care of patients with schizophrenia
-The researcher found that those who took part in standard outpatient care had a 50% relapse rate after nine months, compared to only 8% of those who had taken part in family therapy
-However after two years, the relapse rate for standard outpatient treatment had risen to 75% and 50% for family therapy
-This suggests that family therapy is only effective in preventing relapse in the short term
Evaluation of family therapy (negative length of therapy)
-Family therapy can often take up to a year
-During this time, patients may drop out, especially if their symptoms are severe or if there is a family incident
Token Economies
Token economies are behavioural therapies that are based off of skinners operant conditioning theory
How do token economies work?
-Tokens are used as a type of positive reinforcement
-Tokens provide an immediate reward when a patient displays a predefined target behaviour
-The token can then be exchanged for something the patient wants i.e chocolate or activities
Uses of token economies
-Token economies are used to make patient behaviour more manageable within a hospital setting
-It can also be used to help long term patients transfer back into the community
Negative evaluation for token economies (only manage negative symptoms)
-Token economies do not directly treat schizophrenia symptoms
-Instead, token economies attempt to manage negative symptoms such as loss of motivation and social withdrawal
Positive research evaluation of token economies (effective on negative symptoms)
Research evidence when reviewing 13 studies, found that token economies were effective in improving the negative symptoms of people with schizophrenia
Negative evaluation of token economies
-Token economies are ineffective when used on patients who are severely unresponsive with very strong negative symptoms
