schizophrenia lessons 9-12 Flashcards
what is CBT
Helps patients identify thoughts and change them.
Discussion between patient and therapist.
Doesn’t get rid of symptoms but helps them cope with it
Patient could be set HW to improve functioning such as strategies to counter irrational thoughts: self distraction such as going for a walk.
positive self talk strategies encouraged
stages in cognitive behavioural therapy for psychosis
Assessment - patient expresses thoughts
Engagement - therapist empathises
ABC model - therapist disputes negative beliefs
Normalisation - therapist says some normal people experience delusions when stressed
Critical collaboration analysis - therapist uses gentle questioning
Develop alternative explanations - patient develops alternative explanations for unhealthy assumptions
evaluation of CBTp
ADV: Has less ethical issues than drug therapy as patients feel more control in their therapy and CBT doesn’t involve physical harm
DIS: more expensive treatment on NHS than drugs as it requires highly trained therapists. 1 in 10 SZ patients attend CBT in the uk which shows it isn’t very popular
NICE study on CBT as a treatment for SZ
investigated difference in results between drugs and CBT studied 2000 uk patients. found CBT reduces hospitalisation by 24% and patients were less likely to leave study with CBT than drugs. Rates of suicide and relapse had no difference.
evaluation of NICE CBT study
ADV: can be more economically viable as it reduces hospitality. supports interactionist approach that it should be used with drugs for most effectiveness
DIS: Has culture bias as only tested on UK patients so cannot be generalised. Sample is fairly small so is not objectively robust enough
What is family therapy
form of therapy which involves family members in an open productive discussion. therapist educates family about SZ and talks about symptoms and behaviours. Family encouraged to support each other.
what are the aims of family therapy
lowers expressed emotion
decreases criticism and anger
reduces relapse rates and symptoms of SZ
improves communication and alliances
evaluation of family therapy
ADV: has economic benefits as can save costs in drugs and prevent relapse.
DIS: requires family members to be honest and open and there might be an issue if the family aren’t willing to share sensitive information. Doesn’t cure SZ or reduce symptoms, only helps family manage symptoms
research on family therapy by pharaoh
reviewed 53 studies from different continents
compared family therapy and drug therapy
results found similar outcomes for both
reduces relapse rates but didn’t improve patients being independent
evaluation of family therapy research by pharaoh
ADV: It is found to be effective in improving mental state and social functioning
DIS: criticised because of lack of randomisation in conditions and so it is not fair or objective
what is the interactionist approach
focuses on a combination of biological and psychological factors that could cause schizophrenia and biological and psychological treatments
what are the biological causes of SZ
genetics
neural correlates
dopamine hypothesis
what are the psychological causes of SZ
Family dysfunction
cognitive
what is the distress stress model
SZ is caused by environmental and biological factors. Genes alone don’t cause SZ, it has to be triggered by environment as well
research based on diathesis stress model
Murray - investigated children born after flu epidemic whos mothers has flue when pregnant. These children had 88% more chance to get SZ than children whose mothers didn’t have flu. Flu (stress) causes defects in neural development in brain (diathesis) which can lead to problem of dopamine functioning
evaluation of diathesis stress model for explaining SZ
ADV: psychologist found evidence that stress could be a factor that causes SZ. He found evidence that cortisol levels were very high before the onset of SZ in patients.
DIS: diathesis and stress do not have a single source as genes are polygenic and stress has many factors like poor parenting and trauma
what is the interactionist approach for treating SZ
Combine biological and psychological treatments together. compare treatments and see which combination is best for patient. Drugs and CBT are common together
research on interactionist approach to treat SZ
psychologist studied 103 patients who had high EE families. relapse rates were common when treatments were used alone but when family therapy, social support and drugs were used together there was 0 relapse rates.
evaluation of interactionist approach for treating SZ
ADV: a problem is that it is quite costly at first but at the same time combining treatments are more effective and in the long term can reduce relapse rates so end up being cost effective.
DIS: Can be difficult to decide which combination of treatments to use and which will be most effective.
