Psychological Treatments To Schizophrenia

Question 1

What does Cognitive Behavioural Therapy (CBT) aim to address in patients?

Answer 1

Distorted beliefs that negatively influence feelings and behaviour.

CBT focuses on the relationship between thoughts, feelings, and behaviours.

Question 2

What are delusions a result of?

Answer 2

Faulty interpretations of events.

Delusions can lead to significant distress and impairment.

Question 3

How many sessions does CBT typically involve?

Answer 3

Between 5-20 sessions total, one-to-one or group.

The duration may vary based on individual needs.

Question 4

What is one method patients use in CBT regarding their delusions?

Answer 4

Evaluate content of their delusions/voices to test validity of beliefs.

This process helps in altering maladaptive beliefs.

Question 5

What is the ABC model in CBT?

Answer 5

Activating events, Beliefs, and emotional Consequences.

This model helps in understanding the relationship between thoughts and feelings.

Question 6

What is the purpose of normalisation in CBT?

Answer 6

To reassure patients that many people experience hallucinations and delusions when stressed.

This can reduce anxiety and promote recovery.

Question 7

What does Critical Collaborative Analysis involve?

Answer 7

Gentle questioning to challenge the patient’s beliefs in a non-judgemental atmosphere.

This fosters trust between the therapist and patient.

Question 8

What is the goal of developing alternative explanations in CBT?

Answer 8

To help patients create their own explanations for unhealthy assumptions.

The therapist supports this development through guidance.

Question 9

Who conducted a case study involving a paranoid client and what was the client’s belief?

Answer 9

Turkington et al (2004), who treated a client believing the Mafia were plotting to kill him.

This case illustrates the application of CBT techniques.

Question 10

True or False: In CBT, therapists dispute irrational beliefs through challenging questions.

Answer 10

True.

This is a key component of the therapeutic process.

Question 11

Fill in the blank: Patients are helped to make sense of how their ________ impact their feelings and behaviour.

Answer 11

delusions/hallucinations.

Understanding this impact is crucial for recovery.

Question 12

What is the effectiveness of CBT for schizophrenia?

Answer 12

There is evidence for the effectiveness of CBT, with a significant but small effect on positive and negative symptoms.

Jauhar et al (2014) reviewed 34 studies and found these results.

Question 13

What did Pontillo et al (2016) find regarding CBT?

Answer 13

Pontillo et al (2016) found reductions in auditory hallucinations.

Question 14

What does NICE (2019) recommend for people with schizophrenia?

Answer 14

NICE (2019) recommends CBT for people with schizophrenia, indicating support from research evidence and clinical experience.

Question 15

What is a weakness of the evidence for CBT?

Answer 15

The quality of the evidence is a concern, as different studies have focused on different CBT techniques and symptoms.

Thomas (2015) highlighted these variations.

Question 16

What are some methodological issues in CBT studies?

Answer 16

Some studies fail to randomly allocate patients to conditions or mask conditions for assessors, weakening the validity of meta-analyses.

Question 17

What is the availability of CBT in the UK?

Answer 17

Only 1 in 10 patients who could benefit from CBT are able to access it in the UK, with some refusing treatment or failing to attend.

Question 18

Is CBT suitable for all patients?

Answer 18

CBT is not suitable for all patients; those with extreme agitation may struggle to rationalize or empathize with a therapist.

Question 19

What do recent meta-analyses show about CBT as a sole treatment?

Answer 19

Recent meta-analyses show only a small effect on positive symptoms, which disappeared when symptoms were assessed blind.

Question 20

How is CBT typically administered in treatment?

Answer 20

CBT is generally combined with drug treatment, making its independent effectiveness difficult to assess.

Question 21

What is the main goal of family therapy for schizophrenia?

Answer 21

Family therapy aims to help the family find more positive ways of dealing with the stress of life with a family member with schizophrenia.

Question 22

How does family therapy affect relapse rates?

Answer 22

It should reduce relapse rates, particularly in families with high expressed emotion (EE).

Question 23

What is expressed emotion (EE)?

Answer 23

Expressed emotion refers to the emotional climate in the family, including expressions of anger and guilt.

Question 24

How many sessions of family therapy are typically offered?

Answer 24

Around 10 sessions over 3-12 months are offered.

Question 25

What are the key components of family therapy?

Answer 25

It reduces the emotional climate, encourages setting appropriate limits, and provides information about the illness.

Question 26

What are the phases of Burbach's (2018) Model in family therapy?

Answer 26

Phases 1 and 2: share information and identify resources; Phases 3 and 4: learn mutual understanding and identify unhelpful interaction patterns; Phases 5, 6, and 7: skills training, relapse prevention, and maintenance.

Question 27

What evidence supports the effectiveness of family therapy?

Answer 27

McFarlane (2016) concluded that family therapy is effective for schizophrenia, reducing relapse rates by 50-60%.

Question 28

When is family therapy particularly promising?

Answer 28

Family therapy is particularly promising during times when mental health initially starts to decline.

Question 29

What does NICE recommend regarding family therapy?

Answer 29

NICE recommends family therapy for schizophrenia.

Question 30

What is a benefit of family therapy?

Answer 30

Family therapy is beneficial for the whole family.

Question 31

What does NICE recommend for families dealing with schizophrenia?

Answer 31

NICE recommends family therapy.

Question 32

What is the benefit of family therapy according to Lobban and Barrowclough?

Answer 32

Family therapy is beneficial for the whole family, not just the patient.

Question 33

How does family therapy impact the family of a person with schizophrenia?

Answer 33

Family therapy lessens the negative impact of schizophrenia on the family and strengthens their ability to provide support.

Question 34

What were the findings of Pharoah regarding family therapy compared to medication alone?

Answer 34

Pharoah found mixed results in mental state, increased medication compliance, some improvements in functioning, and a reduction in relapse and hospital admissions during and after family therapy.

Question 35

What did Bird's study reveal about family intervention in early psychosis?

Answer 35

Bird showed that family intervention significantly reduced relapse and readmission rates.

Question 36

What are the overall benefits of family therapy according to the evaluation?

Answer 36

Family therapy can improve clinical outcomes, social functioning, and increase medication compliance.

Question 37

What was a limitation found in Pharoah's meta-analysis?

Answer 37

Many Chinese studies may not have used random allocation of patients to treatment conditions.

Question 38

What did the NICE review of family therapy studies in 2009 conclude about costs?

Answer 38

The extra cost of family therapy is offset by a reduction in hospitalization costs due to lower relapse rates.

Question 39

What impact does family therapy have on family relationships and problem-solving skills?

Answer 39

Family therapy improves outcomes for individuals and has a positive impact on family relationships and problem-solving skills.

Question 40

Does family therapy cure schizophrenia according to biological explanations?

Answer 40

Family therapy does not cure schizophrenia, but studies report significant reductions in symptoms.

Question 41

When might family therapy not provide additional advantages?

Answer 41

If a patient has a good standard of care in a family with relatively low expressed emotion (EE), family therapy may give no further advantages.