Schizophrenia Treatments Flashcards
Why not just medication?
Treatment resistant symptoms
Partially resistant symptoms
Where side effects limit doses of medication
Service user choice
Comorbidities (anxiety, depression, PTSD)
NICE recommended psychological treatments in schizophrenia
Offer CBT for psychosis
Offer family interventions
Consider art therapy
Assess for PTSD and follow PTSD guidlines
Psychological therapies for comorbidities
Depression- behavioural activation
Bipolar- mood management
Trauma- trauma related work, EMDR
Anger management
Anxiety- relaxation, graded exposure work
CBT for psychosis
12-20 sessions
Treatment resistant symptoms
Alternative to medication for distressing symptoms
Aims to relieve distress and increase function
Targets of interventions
Dopamine dysregulation- antipsychotic drugs
Cognitive salience erros- CBT
Appraisal of a situation
Excitement
- heart racing
- feel ready for action
- butterflies in the stomach
Fear
- heart racing
- sweating
- feel tense
- stomach churning
Change appraisal of experiences
Change appraisal of voices
Change appraisal of visual hallucinations
Family interventions
Psychoeducation for families
Support for families, friends and family groups
Specific coping strategies
Specific psychosis based family intervention
Behavioural family therapy
Highly structured therapy
Based on work of Vaughn and Leff 1976 on expressed emotion and risk of relapse
12-16 sessions
2 therapists
Ideally patients who have relapsed and are in close contact with family
Art therapy
Negative symptoms
Concentration
Isolation
Self confidence
Creative medium to help explore and articulate feelings rather than speaking about them
