Schizophrenia - CBTp and Family Therapies Flashcards
Outline CBT for Schizophrenic patients
5-0 sesssions (more than psychopathologies).
Helps patient make sense of hallucinations and delusions. Teaches to cope with symptoms rather than eliminate them.
How does CBT help?
Improves ability to function adequately as reasons for symptoms are known. Normalisation - hearing voices is an extension of a NORMAL experience of thinking in words. Reality testing for delusions. CBT can tackle the anxiety and depression caused by the symptoms.
Specific example CBT
Turkington. Mafia. Reality testing with patient o address irrational thoughts.
Effectiveness of CBT
Jauhar et al
34 studies using CBT for Sz. Small but significant effects on positive and negative symptoms.
Pontillo e al
Reductions in frequency and severity of auditory hallucinations.
NICE recomends CBT to schiophrenic patients
Low quality evidence from varying studies
Thomas et al
Different studies looking at Sz and CBT use different CBT techniques. Symptoms can also differ across cases. Makes it hard to see how effective CBT is for Sz overall.
CBT isn’t a treatment as it does not cure
COUNTERPOINT
Only improves symptoms or helps patients deal with them. Sz seems to be a largely biological disorder CBT ( a psychological treatment ) can only have limited helpfulness.
counterpoint
Reduction of both positive and negative symptoms shows more than just teaching patients how to cope with symptoms.
Outline family therapy
Aims to improve quality of communication and interaction between family members. Based on psychological theories like double bind and schizophrenogenic mother.
How does family therapy help
Pharoah et al
Reduces negative emotions .Expressed emotion. Reduces levels of anger and guilt which cause stress. Stress regularly causes relapse.
Improves families ability to help. Therapeutic alliance. The family agrees on the aims of therapy. Therapist educates the family on Sz behaviours and stigmas. Family is taught o balance between helping patient with Sz and maintaining their own lives.
Specific example Family Therapy
Burbach
model for workig with families.
Includes providing emotional and practical support, identifying which resources the family can and cannot provide and creating a afe space for the individual and family members to express emotions.
Effectiveness of Family Therapy
McFarlane
review of studies. One of most consistently effective treatments for Sz. Reduces relapse rates by 50%-60%. Best when mental health declines initially. NICE recommends family therapy to all patients diagnosed with Sz.
Benefits the whole family
Lobban and Barrowclough
review of evidence. Found that effects on family are important as family usually provide a bulk of the care that the patient receives. Family therapy creates a better functioning family allowing them to provide more support and care. Family therapy has positive effects but not only on identified patient.
Economic benefits
Family therapy reduces relapse rates. NHS does not have to pay for hospitalisations. If family can provide more support and care NHS has to pay for less care workers within the community. Family therapy is good for the economy.
