Psychological Treatments To Schizophrenia Flashcards

1
Q

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

A

Distorted beliefs that negatively influence feelings and behaviour.

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

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2
Q

What are delusions a result of?

A

Faulty interpretations of events.

Delusions can lead to significant distress and impairment.

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3
Q

How many sessions does CBT typically involve?

A

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

The duration may vary based on individual needs.

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4
Q

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

A

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

This process helps in altering maladaptive beliefs.

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5
Q

What is the ABC model in CBT?

A

Activating events, Beliefs, and emotional Consequences.

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

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6
Q

What is the purpose of normalisation in CBT?

A

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

This can reduce anxiety and promote recovery.

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7
Q

What does Critical Collaborative Analysis involve?

A

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

This fosters trust between the therapist and patient.

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8
Q

What is the goal of developing alternative explanations in CBT?

A

To help patients create their own explanations for unhealthy assumptions.

The therapist supports this development through guidance.

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9
Q

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

A

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

This case illustrates the application of CBT techniques.

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10
Q

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

A

True.

This is a key component of the therapeutic process.

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11
Q

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

A

delusions/hallucinations.

Understanding this impact is crucial for recovery.

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12
Q

What is the effectiveness of CBT for schizophrenia?

A

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.

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13
Q

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

A

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

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14
Q

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

A

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

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15
Q

What is a weakness of the evidence for CBT?

A

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

Thomas (2015) highlighted these variations.

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16
Q

What are some methodological issues in CBT studies?

A

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

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17
Q

What is the availability of CBT in the UK?

A

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.

18
Q

Is CBT suitable for all patients?

A

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

19
Q

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

A

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

20
Q

How is CBT typically administered in treatment?

A

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

21
Q

What is the main goal of family therapy for schizophrenia?

A

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

22
Q

How does family therapy affect relapse rates?

A

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

23
Q

What is expressed emotion (EE)?

A

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

24
Q

How many sessions of family therapy are typically offered?

A

Around 10 sessions over 3-12 months are offered.

25
Q

What are the key components of family therapy?

A

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

26
Q

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

A

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.

27
Q

What evidence supports the effectiveness of family therapy?

A

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

28
Q

When is family therapy particularly promising?

A

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

29
Q

What does NICE recommend regarding family therapy?

A

NICE recommends family therapy for schizophrenia.

30
Q

What is a benefit of family therapy?

A

Family therapy is beneficial for the whole family.

31
Q

What does NICE recommend for families dealing with schizophrenia?

A

NICE recommends family therapy.

32
Q

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

A

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

33
Q

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

A

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

34
Q

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

A

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.

35
Q

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

A

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

36
Q

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

A

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

37
Q

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

A

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

38
Q

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

A

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

39
Q

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

A

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

40
Q

Does family therapy cure schizophrenia according to biological explanations?

A

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

41
Q

When might family therapy not provide additional advantages?

A

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.