Treatments based on cognitive explanations Flashcards
What is the cognitive treatment to Schizophrenia ?
Cognitive Behavioural Therapy
CBT
What does CBT work on the assumption of and what is its aim ?
It works on the assumption of dysfunctional thinking
and
aims to identify and change faulty cognition
How does CBT work?
The patient and therapist first form a therapeutic alliance (mutual agreement to work together) and identify the patients irrational beliefs.
It uses Ellis’ ABCDE framework which helps to cognitively restructure irrational beliefs. This uses logic to dispute the irrational beliefs and works using two processes
normalisation - Normalising the symptoms that they have by saying that they are experienced by many other people and they are common. This helps them to feel less alienated
Reality Testing - They test the irrational beliefs against reality to show that they are not accurate
They may also be given coping strategies to help manage their symptoms when they are alone
AO3 strengths of the cognitive treatment to schizophrenia
P- Effective as it has supporting evidence
E- Jauhar et al - reviewed 34 studies of CBT and found that there was small but significant changes to both positive and negative symptoms (P<0.001)
E - NICE (2019) - compared CBT to standard care (medicine) and found a reduction in relapse rates and symptom severity when using CBT
E - Shows that it is more effective than medicine so better to use as also comes with less side effects.
L - Therefore, CBT is effective as it has supporting evidence to prove that when it is used, patients will see positive results.
HOWEVER -
Jauhar et al’s study only had a small sample size so his results aren’t necessarily representative and in NICE’s study, the majority of the CBT group were also on medication so maybe its a combination of the 2 that is more effective than just using one.
P - Ideographic approach
E - It focuses on the individuals goals rather than a generalised treatment such as drugs
E - Therapeutic alliance is formed and a personal plan is created for each individual patient, no one has the same plan or goals. Each therapy session tailored to the needs of the patient.
L - Therefore, the fact its ideographic means that it is better suited to the individual and helps them to be treated at a personal level meaning it can be more effective as they do exactly what they need.
HOWEVER-
It can be a lengthy process as the sessions last a while and each session requires the therapist that they have been working with. However they might be busy with another patient but as each plan is created with the therapist you would have to wait until they are free.
AO3 weaknesses of the cognitive treatment for Schizophrenia
P - It requires self awareness and willingness to engage with process
E - This can be hard for some people. For example, if they have positive symptoms such as delusions and hallucinations, they are going to lack self awareness as they have these irrational beliefs. Similarly if they have negative symptoms such as avolition this may mean they lack the motivation to carry on so might not be effective.
E- This is a weakness as it means that not all people with Schizophrenia can engage properly with this treatment as if their symptoms are severe then they will not be able to access the therapy properly.
L - Not suitable for everyone so lacks usefulness
P- It has practical issues
E- For example, it is extremely time consuming as it takes around 5- 20 sessions to complete and the therapists aren’t always available, making it even longer as you have to wait for your sessions.
E - This can cause it to become expensive as the sessions take time to complete and the therapist will need paying for her time. Similarly, it may lead to the patient dropping out as they may have a sever episode or may simply not have the patience to wait when there is quicker and cheaper alternatives such as drug treatments.
L - Therefore, a weakness is that it has practical issues as it is an extremely time consuming and expensive treatment which can cause dropout rates to be higher. Using treatments like drug therapy may be more beneficial.
