Psychology (Schizophrenia: Psychological Therapies)

Question 1

Explain the 5 techniques of CBT for SZ

Answer 1

ABCDE Model - A identifying activating events

B and the resulting beliefs

C from these events that appear to cause their emotional and behavioural consequences

D Beliefs can be rationalised and disputed

E the effect is restricted beliefs.

Question 2

Outline family therapy for SZ

Answer 2

Research has discovered family environment has potential role in influencing course of SZ - main aim is to attempt to make family life less stressful and so decreasing re-hospitalisation

Question 3

What is the main study regarding the origins of family therapy for SZ?

Answer 3

Brown (72)

Question 4

Outline Brown (72)

Answer 4

SZs in families that expressed high levels of hostility, criticism or over involvement had more frequent relapses than people with the same problems who lived in families that were less expressive in their emotions

Question 5

Name 2 positive points about CBT for SZ

Answer 5

1) Supporting research - found has a significant effect

2) Appropriateness in terms of negative symptoms

Question 6

Name a study supporting the significance of CBT for SZ

Answer 6

Gould (01)

Question 7

Outline Gould (01)

Answer 7

Found all 7 studies in a meta-analysis reported statistically significant reduction in positive symptoms after CBT treatment

Question 8

Name 2 negative points about CBT for SZ

Answer 8

1) How much is due to the effects of CBT alone - often antipsychotic at the same time so difficult to assess
2) Appropriateness in terms of who benefits?

Question 9

Outline the appropriateness of CBT for SZ in terms of who benefits

Answer 9

Use CBT in conjunction with medication seems to have benefits but believed not everyone with SZ may benefit from CBT - study of 142 SZs and Kingdon & Kirschen (06) found many patients not deemed suitable for CBT because thought they would not fully engage with therapy - in particular, found older patients deemed less suitable than younger

Question 10

What is the main study looking into the effectiveness of FT for SZ?

Answer 10

Pharoah

Question 11

Outline Pharoah

Answer 11

Reviewed 53 studies 2002-10 investigating effectiveness of FT - Compliance with medication - compared to standard, the use of FT increases patients’ compliance with medication

Question 12

Name 2 positive points about FT for SZ

Answer 12

1) Supporting evidence - NICE (09)

2) Economic benefits

Question 13

Outline NICE (09)

Answer 13

Meta-analysis of 32 studies and nearly 2500 patients - found significant evidence for effectiveness of FT - when compared with patients receiving standard care alone, was a reduction in hospital admissions during treatment and in severity of symptoms during and up to 24 months following - relapse rate in FI 26% and control 50%

Question 14

Outline the cultural limitations of FT

Answer 14

Evidence has begun to show effectiveness of FT as an addition to antipsychotic drugs but most of this comes from studies conducted outside UK, principally China - NICE (09) expressed view that hospitalisation levels may differ significantly across countries depending on clinical practise within countries, therefore data on hospitalisation rates from non-UK countries might not be applicable to the UK setting

Question 15

Outline the economic benefits of FT for SZ

Answer 15

NICE (09) demonstrated FT associated with significant cost savings when offered to SZs in addition to standard care - the extra cost of FT is offset by the reduced costs of hospitalisation as reduced relapse rates - also evidence FT reduces relapse rates for significant period after completion - means cost savings of FT are even higher

Question 16

What is normalisation in CBT?

Answer 16

Emphasises the psychologist reminding and telling the patient about how many other people struggle with unusual experiences such as hallucinations and delusions. This reduces anxiety, stress and the sense of isolation by making the patient feel less alienated that many other people struggle with the same thing.