Psychological Therapy CBT

Question 1

Cbt is based on the cognitive explanation that schiz symptoms are caused by dysfunctional thought processes

Answer 1

Cbt aims to replace the patients irrational thoughts with rational alternstives. By getting ostirnt to test the reality of their beliefs

Question 2

Cbt can be delivered in group sessions

Answer 2

But is typically delivered on a one to one basis

Question 3

Cbt usually consists of between

Answer 3

5&20 sessions

Question 4

Cbt used to treat schizophrenics is known sd CBTp which stands for

Answer 4

Cognitive behaviour therapy for psychosis

Question 5

CBTp often uses the

Answer 5

ABC model first developed by Ellis

Question 6

A patient is encouraged to identify the activating events that cause distress and positive symptoms

Answer 6

Eg from Chadwick

Patient receiving bad news or something bad happening

Question 7

B Patient explains their irrational beliefs about the events ie delusions

Answer 7

Eg one patient had the delusional belief that he could make bad things happen by simply thinking of them

Question 8

C patient id helped go identify the consequences of these emotions and actions

Answer 8

Eg this caused delusions and probably guilt/anxiety

Question 9

D patient is encouraged to dispute their faulty beliefs and replace them with healthier ones

Answer 9

Eg to test the validity, the therapist showed him a validity of clips and asked the patient to think what might happen in each one

Question 10

E the effect should be a reduction in distress/anxirty and even in delusions/hallucinstions

Answer 10

The patient came to understand that his belief had been irrational and his thoughts could not influence events

Question 11

Critical collaborative analysis

Answer 11

Therapist uses gentle questioning to help the patient recognise their illogical conclusions and eventually come to dispute irrational beliefs.
Questions must be empathetic and none judgemental in order to causing further distress

Question 12

Behavioural experiments/reality testing

Answer 12

The therapist designs practical ways to test the reality of their irrational beliefs and to demonstrate that they are not true.
Should help them to dispute such beliefs

Question 13

Self talk

Answer 13

The patient is encouraged to devise statements that they can say to themselves or positive affirmations

Question 14

Supporting evidence of effectiveness of CBTp
Zimmerman
NICE review

Answer 14

Compared to no treatment at all, cbt better at treating positive symptoms, long lasting up to 12 months

Rehospitalisation rates of patients receiving CBT were reduced for up to 18 months following the treatment

CBT superior to standard care in terms of reducing severity of symptoms and improving social functioning

Question 15

Methodolocially flawed evidence for effectiveness from meta analysis

Answer 15

Do not use random allocation and some do not use the double blind technique.

Researcher bias when assessing patients in the treatment groups

Effectivness of CBT from such studies may have been over estimated

Question 16

Wykes et al found out that the more

Answer 16

Scientifically sound the study, the weaker the effect of CBT

Question 17

A more recent and methodologically sound review from Jauhar et al showed only

Answer 17

A small theraputic effect of CBT on symptoms such as hallucinations and even those effects disappeared when double blind method had been used.

Must therefore question the efficacy of CBT in that it may not be superior to treatment using antipsychotic medication

Question 18

Cbt only effective in certain stages of disorder

Addington and Addington argue

Answer 18

Cbt not appropriate during the acute phase as patients find self reflection difficult

Group sessions could be beneficial once the patient has been stabalized with antipsychotic medication, being around others with similar issues likely to normalise experience and reduce their distress

Only individuals who have greater realisation of their schiz and greater insight into their problems are likely to benefit from more individual sessions

Question 19

Cbt avoids side effects and medical risks of antipsychotic drugs including extra pyramidal side egfrctd

Answer 19

More likely to complete the course of treatment and benefit from improved functioning

Question 20

Ethical issues

Answer 20

Involves challenging patients beliefs
Disputing a belief in a controlling government may interfere with and modify patients politicts and affect their freedom of thought