treatments for schizophrenia - psychological therapies

Question 1

Types of psychological therapy

Answer 1

. family therapy
. cognitive behavioural therapy

Question 2

Cognitive behavioural therapy: background

Answer 2

. commonly used treat patients with Sz
. usually between 5-20 sessions
. conducted in groups or individually
. based on assumption that Sz have irrational unrealistic thought processes
. CBT attempts to challenge these

Question 3

Cognitive behavioural therapy: aim

Answer 3

. help patients identify irrational/delusional thoughts
. change them into more rational ones (less threatening)
. via disputing
. helps reduce positive symptoms (delusions)

Question 4

Cognitive behavioural therapy: process

Answer 4

. once irrational thoughts identified
. e.g. paranoid delusion - aliens trying to abduct
. psychiatrist challenge patients irrational thoughts
. to encourage patients come up with a more plausible less threatening explanation

Question 5

Define empirical disputing

Answer 5

. therapist ask patient where is the evidence of their delusions/hallucinations
. e.g. Has anyone else seen these aliens?

Question 6

How CBT/disputing helps a patient with schizophrenia

Answer 6

. disputing helps patient understand delusions/hallucinations not real
. explain is just a symptom of Sz
. offer more plausible explanation for these symptoms
. will reduce anxiety/distress
. helps patient realise their beliefs (delusions) not based in reality
. thoughts are less threatening

Question 7

Cognitive behavioural therapy: positive self-talk

Answer 7

. if individual hears negative voices
. can say positive statements
. challenge auditory hallucinations

Question 8

Cognitive behavioural therapy: self-distraction strategies

Answer 8

. therapist could teach self-distraction strategies
. personal to the client - whatever they enjoy
. e.g. listening to music to drown out voices when they occur

Question 9

AO3 for CBT as a treatment for schizophrenia: RTS effectiveness by Jauhar

Answer 9

P - research into effectiveness CBT by Jauhar E - reviewed results 34 studies of CBT as treatment for Sz
E - concluded CBT has significant but small effect on both positive and negative symptoms
L - showing that CBT is fairly effective in treating Sz - by challenging patients irrational thoughts can reduce symptoms of depression
CA - However worth noting out of 34 studies CBT only had small impact on Sz symptoms - so placing doubt on effectiveness of CBT as treatment for Sz

Question 10

AO3 for CBT as a treatment for schizophrenia: requires motivation and commitment

Answer 10

P - limitation CBT as treatment for Sz requires motivation and commitment from patients to attend sessions - something that ppl suffering from negative symptoms Sz (avolition) lack.
E - CBT also requires patient to engage with therapy - somebody with positive symptoms of Sz (delusions) may have lack awareness and inaccurate perception reality
E - so in some cases Sz CBT only effective when combined with antipsychotics - cause drugs help patient motivate themselves to attend sessions/increase patients awareness L - so CBT alone may not be effective treatment for all cases of Sz

Question 11

AO3 for CBT as a treatment for schizophrenia: avoids chemical dependence

Answer 11

P - some may prefer this therapy as avoids chemical dependence
E - because CBT encourages individuals to identify/challenge their irrational/delusional thoughts independently, - giving them control over own behaviour
E - unlike drug therapy which imposes chemical straitjacket - as drug controls activity of neurotransmitters in brain (dopamine) to reduce symptoms of Sz - could cause dependence
L so some may prefer CBT as more appropriate treatment for Sz

Question 12

AO3 for CBT as a treatment for schizophrenia: art therapy - alternative

Answer 12

P - alternative therapy may be useful in treating Sz art therapy
E - less well known/less likely to be available to patients
E - art therapy takes place with specially trained art teacher - who has worked with Sz patients - allows patients to interpret their emotions/feelings and express them without necessarily using words in safe environment - also acts as healthy form distraction from various symptoms e.g. disturbing thoughts, hearing voices
L - so art therapy may be more appropriate treatment than CBT for Sz

Question 13

Family therapy

Answer 13

. based on idea that family dysfunction can play role in development of Sz
. altering relationships and communication patterns in dysfunctional families should help Sz’s recover
. works by reducing expressed emotion and stress levels - within family - may contribute to risk of relapse
. therapist meets regularly with patients and family - around 9 months to 1 year - encourage to be open - talk about patient’s symptoms, behaviour, progress

Question 14

The main aim of family therapy is to reduce levels of expressed emotion/stress levels by:

Answer 14

1. improving family beliefs about/behaviour towards Sz
2. reducing stress of caring for relative with Sz
3. decreasing feelings of guilt/anger in family members
4. helping family achieve balance between caring for Sz individual and maintaining own lives

Question 15

AO3 for family therapy as a treatment of schizophrenia: RTS by Leff - outpatient care

Answer 15

P - RTS family therapy as treatment Sz by Leff et al
E - compared family therapy with routine outpatient care for Sz
E - found that in first 9 months of treatment 50% receiving routine care relapsed - compared only 8% receiving family therapy
L - so suggests family therapy is effective therapy for treating Sz

Question 16

AO3 for family therapy as a treatment for schizophrenia: not get to the root cause

Answer 16

P - limitation family therapy as treatment Sz does not get to root cause (aetiology) of Sz
E - works by helping reduce stress of living with Sz in family - for both patient and family E - this does not eliminate symptoms completely
L -so questions appropriateness and effectiveness of therapy as when therapy stops patients could relapse - is what Hogarty et al found in follow up study of patients who received family therapy

Question 17

AO3 for family therapy as a treatment for schizophrenia: emphasis on openness

Answer 17

. family therapy emphasis placed on openness
. can sometimes be issue
. as may cause/reopen family tensions
. some family members may be reluctant to talk about/admit problems
. lowering effectiveness

Question 18

AO3 for family therapy as a treatment for schizophrenia: art therapy - alternative

Answer 18

P - alternative therapy useful treating Sz art therapy
E - less well known less likely to be available
E - art therapy takes place with specially trained art teacher - who has worked with Sz patients - allows patients to interpret their emotions/feelings and express them without necessarily using words in safe environment - also acts as healthy form distraction from various symptoms e.g. disturbing thoughts, hearing voices
L - so art therapy may be more appropriate treatment than family therapy for Sz