Week 7-

Question 1

What are the clinical guidelines for schizophrenia?

Answer 1

• integration of biological and psychosocial interventions
  (psychopharmocology with standard case management does not address all domains, especially cognitive, social and functional impairments)
• CBT should be routinely available when individual’s response to positive symptoms are slow.
• cognitive remediation therapy (improving attention, memory, EF, social cognition) and cognitive compensatory techniques (diaries, calendars, phone reminders) should be available to anyone who has cognitive impairment

Question 2

What do psychological interventions aim to help with in schizophrenia?

Answer 2

• identify triggers and early signs of relapse
• used to assist people to deal with social consequences of illness - dealing with friends, peers, employers, rs
• medication compliance (increase motivation to comply, behavioural strategies to prompt medication taking at correct time; ensure supply does not run out; psychoeducation)

Question 3

What is the evidence for CBT in psychosis?

Answer 3

• evidence-based treatment used as an ADJUNCT to pharmacotherapy to reduce distress and disability associated with psychotic symptoms
• CBT more effective than other talking therapies for HALLUCINATIONS, EMOTIONAL DISTRESS AND DEPRESSION (but not well established over other therapies for mental state and delusions)

Question 4

How does CBT address key issues in psychosis?

Answer 4

• CBT provides alternative ways of coping with strange thoughts and symptoms of schizophrenia (should reduce distress and improve functioning)
• negative symptoms are best addressed with behavioural techniques
• homework is essential
• psychoeducation aims to reduce distress and stigma

Question 5

How is psychoeducation used for psychosis?

Answer 5

• interpretation of intrusions is KEY

- experience intrusive unusual thoughts that people are talking about them

Question 6

What are some methods for providing CBT in psychosis?

Answer 6

• reduction of conviction (goal may not be to remove distorted belief but reducing conviction can be helpful)
• pie charts can be helpful
• PROS and CONS (of holding the belief or acting on it, regardless of accuracy)
• promote internally generated explanations
• behavioural experiment