Psychological Treatments of Schizophrenia- CBT Flashcards
What is the aim of CBT?
- To help patients identify their faulty, delusionary beliefs
- Reduce stress associated with symptoms of schizophrenia
- Develop more rational constructive ways of thinking, coping and functioning
What are the 2 CBT techniques?
- Integrated psychological therapy
- Coping strategy enhancement
What is integrated psychological therapy?
- Tries to identify specific cognitive deficits and treat them in a non confrontational manner
- E.g. clients are taught to recognise and respond appropriately to social cues and understand/evaluate verbal statements
- Could take place in engaging group exercises that emphasise repetitive training which allow schizophrenic patients to refine new behavioural tactics
- Faulty interpretations are challenged using reality tests to identify and remove some false beliefs
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 impact on day to day functioning
- Trains the patient in the use of appropriate coping strategies in response to the occurrence of their psychotic symptoms
- Cognitive strategies can include distracting thoughts and positive self talk
- Behavioural strategies can include relaxation techniques and ways of drowning out hallucinatory voices
If the point is:
A strength of CBT as a psychological treatment is that there is research to support its effectiveness.
What is the evidence and link?
Evidence- Startup et al investigated the effectiveness of CBT by recruiting 90 patients who had been admitted to hospital with an acute episode. 43 were given antipsychotics and nursing care, whilst the other 47 were given the same plus up to 25 90 minute sessions of CBT. They found that 60% of the CBT group showed reliable and clinical improvement, with fewer positive and negative symptoms, compared to 40% of the control group. More importantly, these benefits stood the test of time and remained at 6 and 12 month follow ups, compared to 17% of the control group.
Link- This implies that CBT is an affective treatment, aiding the NHS by reducing the number of people readmitted to hospital.
If the point is:
A strength of CBT as a psychological treatment is that Garrett argued that CBT is an appropriate mechanism to encourage patients to take their antipsychotic medication.
What is the evidence and link?
Evidence- Garrett described successfully using CBT to change a patients mind about taking the antipsychotic drugs she was prescribed and therefore reducing her symptoms in that way.
Link- This shows that CBT can be appropriate for schizophrenic patients.
If the point is:
A weakness of CBT as a psychological treatment is that the appropriateness of it may be questioned, as it may not be suitable for both young and old patients.
What is the explanation, evidence and link?
Explanation- Many clinicians have criticised the use of CBT with schizophrenic patients, as they characteristically do not have coherent thinking and insight into their condition to actually gain therapeutic benefit.
Evidence- For example, many delusionary patients may not accept they are ill and need help in the first place. Kingdon and Kirschen found that clinicians significantly judged older patients as being far less suitable than younger patients to benefit from CBT.
Link- Therefore, CBT may not be an appropriate treatment method for all schizophrenia sufferers.
If the point is:
A weakness of CBT as a psychological treatment is that it is not suitable for all types of symptoms.
What is the evidence and link?
Evidence- Zimmermann et al found that there does seem to be a place for CBT helping with auditory and visual hallucinations that sufferers experience and it particularly helps in reducing the 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.
Link- This could suggest that CBT cannot be used widely by everyone.
What are the evaluation points of CBT as a psychological treatment?
+ Research to support its effectiveness
+ Garrett argued that it is an appropriate mechanism to encourage patients to take their antipsychotic medication
– Its appropriateness may be questioned, as it may not be suitable for both young and old patients
– Not suitable for all types of symptoms
