Schizophrenia- Psychological therapies for schizophrenia Flashcards
Cognitive behaviour therapy (CBT) -
A method for treating mental disorders based on both cognitive and behavioural techniques. From the cognitive viewpoint the therapy aims to deal with thinking, such as challenging negative thoughts. The therapy also includes behavioural techniques.
Family therapy -
A psychological therapy carried out with all or some members of a family with the aim of improving their communication and reducing the stress of living as a family.
Token economies -
A form of behavioural therapy. where desirable behaviours are encouraged by the use of selective reinforcement. For example, people are given rewards (tokens) as secondary reinforcers when they engage in correct/socially desirable behaviours.
The tokens can then be exchanged for primary reinforcers - favourite foods or privileges.
What is cognitive behaviour therapy (CBT) used for in schizophrenia?
CBT is used to help people with schizophrenia identify and challenge irrational thoughts, making them better able to cope with symptoms.
How many sessions does CBT typically involve?
CBT usually takes place for between five and twenty sessions, either individually or in groups.
What is the aim of CBT for schizophrenia?
The aim is to help individuals understand and challenge their delusions and hallucinations, reducing anxiety and improving coping mechanisms.
How does CBT help with hallucinations and delusions?
CBT helps by offering psychological explanations for symptoms, reducing fear and anxiety, and challenging the reality of delusions.
What is an example of CBT challenging a delusion?
A therapist might discuss alternative explanations for a paranoid belief, such as questioning whether the Mafia is truly observing the client, and exploring less threatening possibilities.
What is family therapy for schizophrenia?
Family therapy involves working with families to improve communication, reduce stress, and lower levels of expressed emotion (EE) to prevent relapse.
What are the goals of family therapy?
Goals include reducing stress, improving problem-solving skills, balancing caregiving with personal lives, and improving family attitudes toward schizophrenia.
How does family therapy reduce relapse rates?
By lowering stress and expressed emotion, family therapy increases medication compliance and reduces the likelihood of relapse and hospital readmission.
What are token economies?
Token economies are reward systems used to reinforce desirable behaviors in individuals with schizophrenia, particularly those institutionalized.
How do token economies work?
Tokens (e.g., colored discs) are given immediately for desirable behaviors, which can later be exchanged for tangible rewards or privileges.
What is the purpose of token economies?
They aim to improve socially acceptable behaviors, enhancing quality of life and enabling individuals to live outside hospital settings.
What is the evidence for the effectiveness of CBT in schizophrenia?
Studies, such as those reviewed by Sameer Jauhar et al. (2014), show CBT has a small but significant effect on both positive and negative symptoms.
What is the evidence for the effectiveness of family therapy?
Pharoah et al. found moderate evidence that family therapy reduces hospital readmission and improves quality of life, though results across studies are inconsistent.
What is the evidence for the effectiveness of token economies?
McMonagle and Sultana (2009) found limited evidence, with only one of three randomized studies showing symptom improvement and none providing useful data on behavior change.
Do psychological treatments cure schizophrenia?
No, psychological treatments aim to improve quality of life and symptom management but do not cure schizophrenia.
What are the ethical issues with token economies?
Token economies can discriminate against severely ill patients who cannot comply with desirable behaviors, reducing their access to rewards and privileges.
What ethical issues arise with CBT?
CBT may challenge personal beliefs, potentially interfering with an individual’s freedom of thought, such as questioning political or paranoid beliefs.
What is a limitation of psychological treatments for schizophrenia?
Psychological treatments do not cure schizophrenia and have varying levels of evidence supporting their effectiveness.
What is the quality of evidence for psychological treatments?
Small-scale studies often show positive results but lack control groups or random allocation, leading to overly optimistic conclusions in some reviews.
What alternative psychological treatments are recommended for schizophrenia?
NICE recommends art therapy, provided it is delivered by a qualified therapist experienced in working with schizophrenia.
Should more psychological treatments be made available for schizophrenia?
There may be a case for offering a wider variety of psychological treatments, such as art therapy, to improve outcomes for individuals with schizophrenia.
