Schizophrenia- CBT Flashcards
What is the aim of CBT for SZ?
To identify +correctfaulty interpretations of events
What are the basic assumptions a CBT therapist would have for a SZ paitent?
-They have distorted beliefs which influence their feelings behaviour in maladaptive ways
Identify the steps of treatment for SZ?
-Assesment
-Engagement
-ABC model
-Goal setting
-Normalisation
-Critical ellaboritiveanalysis
-Alternative explanations
Explain what happens during assessment.
-The Paitent expresses their thoughts + experiences
-The therapist identifies symptoms and struggles
Explain what happens during engagement
-The therapist empathises with patient’s perspective +feelings of distress
-Rapport is built so paitent can trust therapist and open up to them
Explain what happens during the ABC model
A- activating event (what has triggered belifs)
B-Paitents belifs
C-Consequences (what is happening as a result of these belifs), these can be rationalised, disputed and eventually chnaged
Explain what happens during normalisation
-Information that many people have unusual experiences such as halluncinations and delusions
-Reduces anxiety + sense of isolation
-Places psychotic experiences on a continuim with normal experiences which leads to them to be less stigmitised/ isolated
-Possibility of recover seems more possible
Explain what happens during critical collaboritive analysis
-Gentle questioning to help understand the illogical deductions and conclusions
-Should be carried out without causing any more distress (otherwise trust/rapport built may be lost)
Explain what happens during goal setting
-Realistic goals are set out based on their current causes for distress
-Motivation for change
Explain what happens when developing alternative explanations
-New ideas about why their symptoms (usually hallucinations or delusions are happening
-Encouraged to evaluate content and consider which parts are faulty (promted +directed by the therapist)
-Constructed through cooperation
What is the negative triad?
What is reality testing?
Why may they be set assingments?
-Self
-Future
-World
-If the client says, ‘I’m useless, and I always fail’, they will be asked whether in reality, they have been successful at something.
-The therapist might ask the client to do something to demonstrate their ability to succeed, may improve general levels of functioning
Give an evaluation point (diificult to acess)
-CBTp is diificult to acess
-Despite being recommended by NICE as a treatment for people with SZ it is estimated that only 1 in 10 people in the UK who can get acess to it
-Haddock et al found that in North West England only 6.9% of paitents could be offered CBTp
-This limits the effcetiveness of CBTpas paitents are unable to participate in the therapy
-Of those who were offered CBTp, a significant number either refuse or fail to attend the therapy sessions which limits the effectiveness even more
Give an evaluation point (motivation)
-CBTp requires motivation paitents may not have
-The lkength of the therapy means that paitents have to be motivated and commited to multiple sessions
-The therapy itself also requires self awareness and a willingness to engage with the process
-However the positive symptoms of SZ lead to a lack of reluctance or inability to engage
-The length of therapy aslo leads to paitents to drop out at times of severe episodes
-Overall this suggests that CBTp may not be an appropriate treatment for all paitents with SZ
Give an evaluation point (effective at certain stages)
-CBTp may be more effective at certain stages of the disorder
-Addington claims that self reflection is not particularly appropriate during the initial acute stage of SZ
-Following stabilisation of the psychotic symptoms with antipsychotics, individuals may then benefit from more group based CBTp
-This can help to normalise their experience by meeting others with similar issues
-Research has found that it is those with more experinece of their SZ symptoms + a greater realisation of them may benefit more from individual CBTp
-This suggests that CBT is effective but may be more appropriate in the later stages of treatment rather than initially
Give an evaluaion point (support for benefits)
-There is evidence to support the benefits of CBTp for SZ
-The NICE review of treatments for SZ in 2014 found consistent evidence that when compared with standard care (antipsychotics alone)
-CBTp was effective in reducing hosptilisation rates up to 18 months after finishing treatment, also found to be effective in reducing symptom severity and improving social functioning
-Hoegies wever most studies on teh effectiveness of CBT have been conducted with paitents treated at the same time as antipsyhcotic medication
-Therefore it is difficult to asses the difficulty of CBTp independent of ap’s
-Overall there seems to be modest support for the effectiveness of CBTp and this supports suggests that it may be a more effective long term therapy than drug treatment as it provides paitents with statregies useful for the future
