Cognitive behavioural therapy Flashcards
What is CBT?
CBT works on the cognitive explanation that dysfunctional thoughts dramatically shape the SCH patient’s behaviour and emotions and need to be addressed.
Aim of CBT is to help patients to identify their faulty, delusionary beliefs and reduce stress associated with symptoms
So the focus is to develop more rational constructive ways of thinking, coping and functioning.
Schizophrenia can lead to a distortion/ breaking from reality.
Cognitive Behaviour Therapy may therefore be effective in grounding these individuals’ beliefs.
It is an irrational belief that is not easily changed by simply reasoning with someone so developing rational constructive thinking is key
What is the aim of CBT?
CBT aims to change the maladaptive thinking of schizophrenic individuals and develop more rational constructive ways of thinking coping and functioning
It is about teaching skills and active therapy
Identification and adaptation of irrational thinking
Teaching of the origins of symptoms
Teaching of relaxation techniques ( Breathing exercises)
What is integrated psychological therapy?
To improve attention and refine concept formation, this technique tries to identify specific cognitive deficits and remedy them in a non confrontational manner.
Clients are taught to recognise and respond appropriately to social cues and to understand and evaluate verbal statements more accurately.
This could take place in engaging group exercises that emphasise repetitive training and allow patients to refine new behavioural tactics.
Another step in IPT is to challenge some faulty interpretations using reality tests to hopefully identify and remove some of the patient’s false beliefs
What is research evidence for challenging false beliefs?
Chadwick reported the case of an individual who believed that he could make things happen by simply thinking them. He was shown 50 video clips and asked to say what would happen next. He did not get a single prediction correct and was able to understand that he did not have the power to influence events after all.
What is coping strategy enhancement?
Tries to teach patients different ways to manage the severity and frequency of their psychotic symptoms and reduce distress and their impact on day to day functioning.
It is based on through behaviour analysis of each symptom and the assessment of any coping strategy that the subject may already employ. They are then trained in the use of appropriate coping strategies in response to the occurrence of their psychotic symptoms.
Cognitive strategies can include distractive thoughts and positive self-talk, whereas behavioural strategies can include relaxation techniques, and ways of drowning out hallucinatory voices.
Was this successful?
Tarrier found 73% of their sample reported that they were successful in managing their symptoms
CBT - Supporting research?
Startup recruited 90 patients who were admitted to hospital after an acute episode of SZ. 43 got the standard care of antipsychotics and nursing whilst the other 47 got the standard care plus up to 25 90 minute CBT sessions. They found that 60% of the CBT group showed clinical improvements compared to 40% of the control group. These benefits remained at 6 and 12 month follow ups compared to 17% for the control groups.
CBT - Alternative treatments?
Biological treatments such as AP medication can help patients if they are used alongside CBT as when they are combined the medication could suspend delusionary thoughts allowing the patients to address the more cognitive issues related to the disorder.
CBT - Reductionist?
Basis is environmental as it focuses on the impact of events in the environment and how they are interpreted, which is only at the cognitive level. This ignores treatment options which are based on biological factors such as AP medication. This implies that we should look at more than one level of explanation to treat complex disorders.
CBT - Not appropriate?
SZ patients characteristically do not have the coherent thinking and insight into the condition to actually gain therapeutic benefit. Many delusionary patients may not accept that they are ill. Kingdon and Kirschen found that clinicians significantly judged older patients as being far less suitable and appropriate than younger patients to benefit from CBT due to age related impact cognitive abilities.
