SZ - CBT, family therapy and token economies Flashcards
Who devised family therapy as a SZ treatment and why?
Falloon et a. (1985)
Family management to be used when a patient leaves hospital and returns home.
Based on psychological explanations for SZ like family dysfunction.
What does family therapy aim to do?
- Give the p a supportive environment to return to that will help prevent relapse
- Teaches everyone in family to be constructive, undemanding and empathetic w/ SZic sufferer
- Told not to have high expectations of SZic and avoid stressful interactions
What are the factors involved in a families psycho education?
- Provide ongoing support and empathetic engagement
- Clinical resources are available in a crisis
- Ps advised to enhance their social network and develop good communication skills
- Families are considered part of the solution rather than the problem
How is family therapy effective?
Pharaoh et al. (2010) carried out meta-analysis of 53 studies and compared outcome of FT w/ standard care.
Relapse rates lower among SZics receiving FT in the 2 yrs after plus higher compliance w/ taking medication.
However there were mixed findings in respect to improved mental state and social functioning
What is a weakness of the effectiveness of FT?
On its own FT is very unlikely to lead to a reduction of symptoms and needs to be used alongside drugs which SZics are always likely to need and use.
Leads to Qs about the importance and effectiveness of FT.
What is a strength of FT in terms of appropriateness?
Evidence that family relationships are important in the maintenance of SZ which means it make sense to offer therapy for dealing w/ this.
65% of SZics return to live w/ their families - more than ever before, important it is a stress free environment for recovering.
What are the issues w/ individual diff.s in FT?
Significant no. of ps unmarried.
May have experienced family breakdown since developing disorder.
May not belong to a functional family.
As a result of these factors FT cannot be implemented.
What form of CBT is used to treat sz?
Coping strategy enhancement
Why is CSE used to treat sz?
Many SZics already have coping strategies to deal w/ their symptoms.
What happens during CSE?
SZic asked Qs to establish the content of their hallucinations and delusions, their triggers and coping strategies they use to deal w/ these.
They are asked to rate their diff. coping strategies and the one w/ the highest rating is focused on in CSE session.
What are the 5 main features of CSE?
- Therapeutic situation is collaborative
- Delusions and hallucinations normalised
- 1 delusion or hallucination selected for treatment w/ most effective coping strategy
- P give hw to implement strategy
- Discussions abt. making strategy more effective
CBT AO3: What evidence is there that it is effective?
Zimmerman (2005) found that CBT was better at treating positive symptoms of sz than having no treatment at all.
Positive effects could be seen 12 months after.
CBT AO3: What evidence is there that CBT is not effective?
Addington and Addington (2005) highlighted effectiveness was dependent on the stage of the disorder.
Less likely to be effective in initial acute phase - self reflection not appropriate.
Better once psychotic symptoms stablised w/ medication.
CBT AO3: Why is CBT an appropriate treatment for sz?
Many key symptoms of sz are cognitive so it makes sense to use a therapy where we focus on cognitions to treat it.
Based on idea that SZics already have coping strategies and makes sense to develop these techniques and enhance them.
CBT AO3: Why does it have a high drop out rate?
It is hard and requires focus and effort that someone suffering from a mental health issue doesn’t always have. Many ps dropping out means it is not likely to be successful.
