psychological therapy for schizophrenia: CBT Flashcards
what are the aims of CBT, how long does does it last for
aims to challenge irrational beliefs and deal with the behaviour that results from irrational beliefs.
usually takes place over 5-20 sessions
Outline ways in which CBT might help a client suffering from hallucinations and delusions.
helps a client make sense of their irrational cognitions (delusions and hallucinations)
achieved by explaining to the client the biological basis to SZ or that the ‘voice’ comes from a malfunctioning speech centre in the brain, and cannot hurt them if they ignore it.
may explain that voice-hearing is an extension of the ordinary experience of thinking in words. This is called normalisation
this is less frightening and therefore less debilitating.
how might CBT challenge irrational beliefs
the client and therapist jointly examine the likelihood the belief is true, looking for evidence and counterevidence. this is a process of reality testing.
how might CBT still help someone who is resistent to reality testing
can still provide the person with skills to tackle the anxiety and depression that may result from schizophrenia
what are some important features of CBT
building rapport between the therapist and patient
patient identifies triggers and old maladaptive coping strategies
patient and therapist work together to develop new coping strategies targeting specific symptoms
patient is given homework - a form of behavioural activation.
how has CBT been enhanced by Tarrier to focus specifically on patients with SZ
focuses on building on SZ’s existing coping strategies, helps to identify possible explanations for their cognitive symptoms.
patients acquire skills to deal with symptoms eg:
cognitive - distraction, concentrating on specific task, positive self talk.
behavioural - relaxation techniques, noise cancelling headphones to avoid sensory overload.
does CBT deal with the root cause? (AO3)
may not treat the root cause of schizophrenia as in many cases the distal cause is biology, however does help the patient to deal with their symptoms by providing context to what causes them, and the skills to manage them. Therefore likely provides the patient with long term behavioural and cogntive skills for dealing with SZ resulting in a better quality of life for patients.
What evidence is there for the effectiveness of CBT (AO3)
Juahar et al meta-analysed 34 studies of CBT with schizophrenia. Concluded there was clear evidence for small but significant effects on both positive and negative symptoms
NICE reccomends CBT for schizophreia.
Shows that there is both research and clinical experience to support the efficacy of CBT.
What are some practical barriers that may limit the efficacy of CBT (AO3)
CBT takes place over 5-20 sessions therefore this recquires lots of motivation and time from the patient to effectively engage with the treatment.
in addition rapport between the patient and therapist is important, however some patients may be too paranoid or anxious to develop such a trusting alliance and so this may mean that CBT is not suitable for everyone.
While CBT may not be favourable to use in isolation, how can it be used in a hollistic way to treat patients (AO3)
CBT can compliment other treatments for example, can be used in conjunction with antipsychotics. This helps deal with the biological basis of SZ and so may reduce the symptoms to a lower level, which is more manageable for the patient to allow them to engage with CBT. Some evidence suggests this combined therapy is more effective than antipsychotic drugs or CBT alone.
why might CBT be more favourable than antipsychotics (AO3)
CBT has very few side effects. By comparison, antipsychotic drugs carry a risk of serious and potentially fatal side effects such as pyramidal symptoms, increased risk of heart attack, and weight gain.
