SZ: psychological treatments

Question 1

A01 family therapy

Answer 1

-Aims to reduce Expressed emotion (EE) and stress in family setting to help reduce SZ symptoms
-3-12 months, 10 sessions
-Family has psycho education (knowledge on SZ and how to deal with it) encouraged to support but place boundaries
-SZ patient encouraged to talk about what support they need

Question 2

A01 CBTp

Answer 2

-Identify faulty beliefs, which may influence feelings and behaviour in maladaptive ways
-aims to establish links between thoughts, feelings and actions
-16 sessions minimum

Question 3

Steps of CBTp

Answer 3

Assessment- set realistic goals for therapy, patient talks about current experiences
Engagement- therapist empathises with patient, stresses that explanations can be developed together
-ABCDE
-Normalisation- informs that symptoms happen to many people under different circumstances
-Critical collaborative analysis- reality testing through gentle questioning
Developing alternative explanations- patient develops their own alternatives

Question 4

A03 of family therapy

Answer 4

-Support ev: Anderson et al- 40% relapse drugs only, 20% when family therapy or social skills, 5% when combinations validates treatment as benefits SZ patient
-Economic benefits
-Not effective alone, may only reduce relapse when severe symptoms controlled with other therapies

Question 5

A03 of CBTp

Answer 5

-Supporting ev: NICE- CBT more effective than antipsychotics in reducing symptom severity
-However hard to explain casual effect- Tarrier et al noted that meds and doctors meetings usually happen together, so hard to compare separately. But both better than drugs alone
-Not effective for those in acute stages of SZ