SCHIZOPHRENIA: Cognitive Behavioural Therapy

Question 1

What is the difference between CBT in depression and SZ?

Answer 1

Normal CBT is inappropriate for psychotic disorders. SZ is largely biological and cannot be ‘cured’. In depression, we try to change behaviours in order to solve the problem but in schizophrenia, we try to change behaviours in order to cope with the problem

Question 2

What does CBT for psychosis involve?

Answer 2

• Identify irrational thoughts and challenge them and reality test them to reduces distress.
• 5-20 sessions, with NICE recommending at least 16 sessions.
• Assessment where the patients express their experiences and realistic goals are set for therapy.
• Uses the ABCDE model

Question 3

What is the ABCDE model used in CBTp?

Answer 3

Identify an Activating event (A) and the resulting beliefs (B) from these events that appear to cause their emotional and behavioural consequences (C). Can be rationalised and disputed (D) , leading to the effect (E) of the restructured beliefs

Question 4

What is Normalisation in CBTp?

Answer 4

patient learns that many people have unusual experiences with hallucinations and delusions in many different circumstances. This reduces anxiety and sense of isolation by making the patient feel less alienated and stigmatised. This makes the possibility of recovery seem more likely.

Question 5

What is Critical Collaborative Analysis in CBTp?

Answer 5

The therapist uses gentle questioning to help the patient to understand and challenge illogical deductions and conclusions. e.g. ‘if the voices you hear are real, why can no one else hear them?’