other treatments Flashcards
what is cognitive behavioural therapy?
a treatment of abnormality that modifies thought patterns to alter behavioural and emotional states
how does CBT relate to schizophrenia?
problems with perception of the self and distorted perceptions underpin the disorder, so CBT aims to resolve this
what is the typical process for CBT?
-antipsychotics given first to reduce psychotic thought processes
-CBT is then taken once every 10 days for 12 sessions
-drawings are often used to display links between patients thoughts, actions and emotions
what is personal therapy?
a CBT approach involving detailed evaluation of problems and experiences, their triggers, consequences and strategies used to cope
-cognitive techniques used, such as distraction from intrusive thoughts, relaxation strategies, challenging meaning of intrusive thoughts and increasing/decreasing social activity to distract from low moods
why is PT used after discharge?
can help recognise signs of relapse
what is rational emotive therapy?
used to treat emotional instability through muscle relaxation techniques to detect gradual anger buildups, and then apply relaxation skills
research on CBT
-zimmerman et al 2005 - meta-analysis of 14 studies of CBT involving 1484 p’s, found CBT significantly reduced positive symptoms, and it was especially beneficial for those with short-term acute schiz episodes
-jauhar et al 2014 - meta-analysis of 50 CBT studies, finding only a small therapeutic effect on symptoms, which disappeared using blind testing (when researchers don’t know they had CBT)
evaluate the use of CBT
-evidence says CBT combined with drugs is more effective than either alone
-training of CBT practitioners is essential, requiring compassion and empathy
-CBT isn’t suitable for all, especially those too agitated to form trust with practitioner
-blind testing hasn’t always been used in CBT testing, making assessment of the treatment difficult
-fewer side effects and is more expensive
-Trower et al 2004 - CBT doesn’t actually reduce symptoms, just makes them easier to deal with
what is family therapy?
a treatment revolving around altering communication systems within families
sees family dysfunction as causing schizophrenia
what are the main aims of family therapy?
-improve positive and decrease negative forms of communication
-increase tolerance levels and decrease criticism levels between family members
-decrease feelings of guilt and responsibility for causing the illness among family members
how does family therapy work?
family and patient are encouraged to talk openly about the patients symptoms, behaviour, treatment progress and how the illness affects them
also taught to be caregivers and how to support each other
whats the time frame for family therapy?
usually between 9 months and a year, focus is on reducing symptoms and providing skills that can be continued once therapy has ended
research on family therapy
-xiong et al 1994 - randomly allocated 63 chinese patients with schiz to either standard drug therapy, or drugs and family therapy. after 1 year, 61% of just drugs relapsed (36% hospitalised), compared to 33% relapse (12% hospitalised)
evaluate family therapy
-emphasis on openness, can have family members reluctant to share sensitive info that can cause tension
-useful for p’s that lack insight into their illness as family can assist
-decreases relapse rates / hospitalization, and educated family on managing illness, decreasing the need for clinicians (Cost effective)
-beneficial for those living at home
-combo is desirable, but cost restrains sometimes make this not possible
-schizophrenia commission 2012 estimates FT is cheaper than standard care by £1004 a patient over 3 years
what are token economies?
reinforcing behaviours with awarding tokens that can be exchanged for material goods
-mainly used for long-term hospitalized patients
-good for negative symptoms like low motivation
-uses operant conditioning principles
