schizophrenia - 1.5

Question 1

psychological treatments for SZ

Answer 1

family therapy

CBT

Question 2

psychological method of managing SZ

Answer 2

token economies

Question 3

CBT for treating schizophrenia A01

Answer 3

doctors attempt to challenge and dispute delusional beliefs

1. explanation - patient explains their symptoms
2. normalisation - doctor explains patients’ feelings are normal
3. challenging - doctor challenges beliefs and experiences
4. alternative explanations- patient is asked to develop alternative explanations for beliefs and experiences

CBT aims to treat the dysfunctional thought processes that the patient is having

CBT challenges and corrects the biases in reasoning that cause the symptoms of schizophrenia

Question 4

main aim of CBT

Answer 4

to challenge patients’ irrational beliefs and though processes patient is having

Question 5

4 steps of CBT

Answer 5

explanation

normalisation

challenging

alternative explanations

Question 6

explanation

Answer 6

patient explains their symptoms

Question 7

normalisation

Answer 7

doctor explains patients’ feelings are normal

Question 8

challenging

Answer 8

doctor challenges beliefs and experiences

Question 9

alternative explanations

Answer 9

patient is asked to develop alternative explanations for beliefs and experiences

Question 10

strength of CBT study support

Answer 10

study support comes from NICE - conducted a review, patients in studies either given CBT + antipsychotics or just antipsychotics, lab experiments + independent groups design, found that treatments involving CBT were more effective, given CBT less likely to relapse

Question 11

limitation of CBT - availability and cost

Answer 11

requires lots of expensive sessions which are usually 1:1 and require multiple sessions, limited availability of the treatment

Question 12

limitation of CBT - study limitation

Answer 12

not all studies in the review used random allocation to assign participants e.g. just did first 20 participants to experimental group, studies couldn’t control participant variables that might have influenced the patients behaviour e.g. patients given CBT might have already had less severe symptoms than the control group, confounding variables make it seem more effective than it is

researchers knew which experimental group the patients had been assigned to, not blind, may have displayed personal bias when assessing symptoms, effectiveness may have been exaggerated, lacked objectively

Question 13

family therapy

Answer 13

therapy which involves family members of individual with SZ

Question 14

aim of family therapy

Answer 14

reduce stress and help family members process their thoughts and feelings about the illness

find a practical solution to situation

Question 15

3 steps of family therapy

Answer 15

1. educate family about symptoms of schizophrenia
2. teach new coping strategies to manage patients’ symptoms
3. change the family’s communication style, reduce expressed emotion

Question 16

family therapy study support

Answer 16

pharoah et al’s review

aimed to investigate effectiveness of combining family therapy and medication

those who received family therapy were more likely to take medication consistently + less likely to relapse into severe symptoms

however, there was less clear evidence family therapy reduced the number of symptoms or improved the patient’s general mental health

Question 17

strength of family therapy cost effective

Answer 17

NICE conducted a review of cost of family therapy compared to antipsychotics

less likely to relapse, less likely to go back to hospital

reduces cost of looking after SZ patients

saves NHS money

Question 18

limitations of family therapy study support

Answer 18

many studies in the review didn’t use random allocation

participant variables weren’t controlled

e.g. patients in group receiving therapy may have already had a less strong stress response to expressed emotion

(confounding variables)

Question 19

token economy

Answer 19

form of psychological therapy based on operant conditioning, which uses a reward system to encourage desired behaviour

Question 20

what behaviour do token economies encourage?

Answer 20

positive, adaptive behaviour

Question 21

what can tokens be exchanged for?

Answer 21

a reward

Question 22

how do token economies use operant conditioning?

Answer 22

through positive reinforcement

associate actions with token

Question 23

how do token economies use classical conditioning?

Answer 23

token is a NS at first

CR is developed and token becomes CS

token is associated with a reward

Question 24

aim of token economies

Answer 24

incentivise SZ patients to behave in ways which are socially acceptable which helps to manage illness

Question 25

what do tokens act as?

Answer 25

secondary reinforces

Question 26

why are the tokens secondary reinforces and not primary reinforcers?

Answer 26

it isn’t the tokens themselves that provide the reward, it’s what they can do with the tokens

e.g. primary reinforcement of sweets

Question 27

primary reinforces in token economies

Answer 27

the reward

not the token

Question 28

support for token economies

Answer 28

dickerson et al

11/13 studies reported improvements in behaviour after token economy in hospital was implemented

particularly effective when combined with other therapies

Question 29

limitation of the study support for token economies

Answer 29

there was no control group, used on all patients at same time

decreases validity

can’t establish cause and effect as behaviour may have just improved over time

Question 30

limitation of token economies application

Answer 30

might not apply outside clinic

if not immediately rewarded, might not form association

to immediately reward, need to monitor behaviour all the time

hard to do outside hospital

e.g. may see therapist once a week

token economies less effective outside hospital setting

Question 31

limitation of token economies further concerns

Answer 31

some consider them unethical

could make them feel humiliated or distressed, treated like a child

could have negative effects if no longer rewarded outside hospital

may stop producing behaviour

become dependent on reward