Schizophrenia: CBT and family therapy Flashcards
What are the two types of cognitive therapy used to treat SZ?
- CBT
- Family therapy
How does CBT treat SZ? (AO1)
- CBT can help a client make sense of how their irrational cognitions (e.g. hallucinations, delusions) impact their emotions and behaviour.
- Understanding where their symptoms originate from can help with this- e.g. if a SZ client experiences auditory hallucinations from demonic voices, the therapist explaining that this is caused by a malfunctioning speech centre in their brain and they cannot hurt them, they are much less frightening.
- This will not eliminate the symptoms of SZ, but can help manage them.
- Normalisation can also occur- where the therapist explains that audinary hallucinations are an extension of the normal experience of thinking in words.
- Delusions can be challenged by therapists using a reality-testing method to examine the likelihood of a delusion being true.
What 3 ways does family therapy treat SZ? (AO1)
- Reduces negative emotions
- Improves the family’s ability to help
- A model of practice
Explain how ‘improves the family’s ability to help’ as a division of family therapy can treat SZ:
Improves the family’s ability to help:
- Therapist encourages family members to form a therapeutic alliance whereby they all agree on the aims of the therapy.
- Therapist tries to improve the family’s beliefs about SZ.
- Therapist encourages family members to create a balance between caring for the SZ individual and maintaining their own lives.
Explain how ‘reduces negative emotions’ as a division of family therapy can treat SZ:
Reduces negative emotions:
- Family therapy will occur with the SZ individual and their (dysfunctional) family.
- Aims to reduce levels of expressed emotion- especially emotions such as anger and guilt which create stress.
- Reducing stress is important to reduce the likelihood of relapse.
Explain how ‘a model of practice’ as a division of family therapy can treat SZ:
- Burbach proposed a 7-step model for working with families dealing with SZ.
- Phase 1: sharing basic information and providing practival emotional and physical support.
- Phase 2: Identifying resources that family members can or cannot offer.
- Phase 3: Encourages mutual understanding, creating a safe space for all family members to express their feelings.
- Phase 4: Identifying unhelpful patterns of interaction.
- Phase 5: Skills training (e.g. stress management techniques).
- Phase 6: Relapse prevention planning
- Phase 7: Maintenance for the future
Name the 3 evaluation points for CBT to treat SZ:
1) Evidence of effectiveness (S)
2) Quality of evidence (L)
3) Not a cure (L)
Explain ‘evidence of effectiveness (S)’ as an evaluation point for CBT to treat SZ:
- A strength of using CBT is its effectiveness.
- Jauhar reviewed 34 studies of using CBT for SZ, concluding that there is clear evidence of small but significant effects on both positive and negative symptoms.
- Clinical advice from the National institute for Health and Care excellent (NICE), recommends CBT for SZ.
- Suggests that both research and clinical experience support the benefits of CBT use for SZ.
Explain ‘quality of evidence (L)’ as an evaluation point for CBT to treat SZ:
- A limitation is the wide range of techniques and methods used to study CBT for managing SZ.
- CBT techniques and methods vary widely from one case to another.
- Thomas argues that different studies have involved the use of different CBT techniques on patients with different combinations of symptoms.
- The overall modest benefits of CBT probably conceal a wide variety of effects that different CBT techniques have.
- Makes it hard to conclude how effective CBT will be for a particular individual with SZ.
Explain ‘Not a cure (L)’ as an evaluation point for CBT to treat SZ:
- A limitation is that using CBT to manage SZ does not treat it, but only improves the qulity of life for those with SZ.
- As SZ appears to be largely a biological condition we expect that a psychological therapy like CBT only benefits people by improving their ability to live with SZ.
- E.g. CBT for SZ may improve an individuals ability to ignore the symptoms of SZ- leading to decreased anxiety, but will not eliminate these symptoms.
- Suggests that CBT is not a full treatment for SZ.
What are the three evaluation points for using family therapy to manage SZ?
- Evidence of effectivness (S)
- Benefits whole family (S)
- Economically beneficial (S)
Explain ‘evidence for effectiveness (S)’ as an evaluation point for using family therapy to manage SZ:
- A strength is the evidence of family therapy’s effectiveness.
- McFarlane concluded that family therapy was one of the most consistently effective treatments available for SZ
- Relapse rates were found to be reduced by around 50-60%.
- Clinical advice from NICE recommends family therapy for everyone with a diagnosis of SZ.
- Suggests that family therapy is likely to benefit those with both early and developed SZ- as well as their families.
Explain ‘benefits whole family (S)’ as an evaluation point for using family therapy to manage SZ:
- A strength is that family therapy benefts the whole family.
- Family therapy is desgined to help both the identified patient and their families.
- Research concludes that this is important because it is often the families that provide most of the care for SZ individuals.
- By strengthening the functioning of the whole family, family therapy lessens the negative impact of SZ on other family members and strengthens the ability of the family to support the SZ individual.
- Suggests that family therapy has wider benefits beyond only impacting the SZ client.
Explain ‘economically beneficial (S)’ as an evaluation point for using family therapy to manage SZ:
- A strength is that family therapy benefits the state as well as the identified individual.
- Family therapy significantly reduces relapse rates and improves the family’s ability to care for the SZ individual.
- This means that the state will not have to pay as much for clinical care and benefits.
- Suggests that the family is cost-effective in the long-term to the state, as well as being beneficial to treated individuals.
