THE PSYCHOLOGICAL TREATMENT: COGNITIVE BEHAVIOURAL THERAPY

Question 1

define CBT (3)

Answer 1

• method for treating mental disorder based on both cog and behavioural techniques
  
  • from cognitive viewpoint therapy aims to deal with thinking eg challenging negative thoughts
  • the therapy also includes behavioural techniques

Question 2

what does the patient do in CBT (3)

Answer 2

• may be taught to recognise examples of dysfunctional or delusional thinking⇒ irrational thoughts
  
  • then may receive help on how to avoid acting on these thoughts.
  • This will not get rid of the symptoms of schizophrenia but it can make patients better able to cope with them.

Question 3

how can CBT help patients to make sense of symptoms like delusions (3)

Answer 3

• making them understand where these symptoms come from can be helpful eg hearing voices and believing voices are demons→ they will naturally be afraid
  
  • offering the psychological explanation like cognitive model for the existence of delusions can help reduce this anxiety
  • thus being challenged so patient learn their beliefs are not based on reality

Question 4

• what is the central idea of CBT (7)

Answer 4

Patients problems are based on incorrect beliefs and expectations. CBT aims to identify and alter irrational thinking including regarding:

- General beliefs.
- Self image.
- Beliefs about what others think.
- Expectations of how others will act.
- Methods of coping with problems.

In theory, when the misunderstandings have been swept away, emotional attitudes will also improve.

Question 5

• what is assessment in CBT (what it is and 3 examples)

Answer 5

The therapist encourages the patient to explain their concerns.

- describing delusions
- reflecting on relationships
- laying out what they hope to achieve through the therapy.

Question 6

what is engagement in CBT (3)

Answer 6

• The therapist wins the trust of the patient, so they can work together.
  
  • This requires honesty, patience and unconditional acceptance.
  • The therapist needs to accept that the illusions may seem real to the patient at the time and should be dealt with accordingly.

Question 7

what is ABC in CBT

Answer 7

Get the patients to understand what is really happening in their life:

A: Antecedent - what is triggering your problem ?

B: behaviour – how do you react in these situations ?

C: Consequences – what impact does that have on your relationships with others?

Question 8

what is normalisation in CBT

Answer 8

Help the patient realise it is normal to have negative thoughts in certain situations. Therefore there is no need to feel stressed or ashamed about them. Eg not much sleep or food causing it

Question 9

what is critical collaborative analysis in CBT (2)

Answer 9

carrying on a logical discussion till the patient begins to see where their ideas are going wrong and why they developed.

Work out ways to recognise negative thoughts and test faulty beliefs when they arise, and then challenge and re-think them.

Question 10

what is learning alternative explanations in CBT (2)

Answer 10

• Helping the patient to find logical reasons for the things which trouble them
  
  • let the patient develop their own alternatives to their previous maladaptive behaviour by looking at coping strategies and alternative explanations.

Question 11

what did Tarrier et al introduce

Answer 11

Coping Strategy Enhancement (CSE)

Question 12

why did Tarrier et al introduce Coping Strategy Enhancement** (CSE)

Answer 12

used detailed interview techniques, and found that people with schizophrenia can often identify triggers to the onset of their psychotic symptoms, and then develop their own methods of coping with the distress caused. These might include things as simple as turning up the TV to drown out the voices they were hearing!

Question 13

what was Tarriers findings in his method for studying Coping Strategy Enhancement** (CSE)

Answer 13

At least 73% of his sample reported that these strategies were successful in managing their symptoms.

Question 14

what was the aim of Coping Strategy Enhancement** (CSE) introduced by tarrier as a replacement for cbt

Answer 14

teach individuals to develop and apply effective coping strategies which will reduce the frequency, intensity and duration of psychotic symptoms and alleviate the accompanying distress.

Question 15

what are the two component’s to Coping Strategy Enhancement** (CSE) introduced by tarrier as a replacement for cbt

Answer 15

1. Education and rapport training: therapist and client work together to improve the effectiveness of the client’s own coping strategies and develop new ones.
   
   2. Symptom targeting: a specific symptom is selected for which a particular coping strategy can be devised Strategies are practised within a session and the client is helped through any problems in applying it. They are then given homework tasks to practice, and keep a record of how it worked

Question 16

what did Tarrier find when reviewing CBT trials

Answer 16

finding evidence of reduced symptoms, especially positive ones, and lower relapse rates.

Question 17

evaluate -ves of CBT (5)

Answer 17

• Requires self-awareness and willingness to engage – Held back by the symptoms schizophrenics encounter – It is an ineffective treatment likely to lead to disengagement.
  
  • Lengthy – It takes months compared to drug therapy that takes weeks which leads to disengaged treatment as they don’t see immediate effects - A patient who is very distressed and perhaps suicidal may benefit better in the short term from antipsychotics.
  • ethical issues: challenging persons paranoia→ but what point does this interfere with persons freedom of thoughts eg challenging patients belief can be done in high controlling governmental way to modify their politics
  • improves quality of life but does not cure eg CBT can be suggested that it is of little use in the early stages of an acute schizophrenic episode, but perhaps more useful when the patient is more calm and beginning to worry about how life will be after they recover. In other words, it doesn’t cure schizophrenia, it just helps people get over it.