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Describe cognitive behavioural therapy as a psychological treatment of sch

- Common on NHS but only recently introduced; often used in conjunction w/ drug therapy as sch patients are psychotic and can't identify their own symptoms
- 5 to 20 sessions (group or 1:1); group is efficient and cheaper but less tailored to individual so less individual success; 1:1 is better for individual progress but is more expensive and has a longer waiting list
- Aims to identify and change irrational thoughts by discussion of beliefs and how likely they are to be true, then challenging them with less threatening possibilities
- CBT doesn't cure sch, but just helps patients to deal w/ symptoms better. Educates patients about faulty processing and understand their symptoms better; reduces anxiety and fear
- Personal therapy (PT) is a special type of CBT used w/ sch:
- Identifies triggers and develops strategies to cope w/ them
- Clients taught relaxation techniques, taught to manage (either inc or dec) their social activity, taught distraction techniques for hallucinations and delusions e.g. listen to loud music to "drown out" voices and putting a phone to their ear when they want to talk to the voices so people don' react so negatively to them


Evaluate cognitive behavioural therapy as a psychological treatment of sch

(+) NICE suggests CBT w/ drugs is more effectve than just drugs alone
(-) Unclear on whether CBT is any good on its own
(-) Jauher (2014) found researcher were more likely to note improvement of same patients when they were aware they had received CBT than when they were unaware; researcher bias
(-) Only 1 in 10 patients have access to CBT due to lack of funding
(-) CBT doesn't cure sch


Describe family therapy as a psychological treatment of sch

Aims to improve communication and reduce high levels of EE
Techniques include...
- Educating family about causes and symptoms of sch
- Talk about how sch patient feels w/ family
- Talk about how family feels having a sch relative
- Reduce anger and guilt
- Training to deal w/ +ve symptoms i.e. train family on how to respond to patient's hallucinations and delusions
- Identify and develop techniques to deal w/ triggers
Family therapy is given alongside drugs; if anger and guilt are reduced the family can ensure that patient complies w/ drug treatment


Evaluate family therapy as a psychological treatment of sch

(+/-) Leff (1985) found that family therapy is very effective in the short term but has weaker effects in the long term after the sessions have finished
(-) Family therapy may only work as family and patient try to please the therapist
(+) Family therapy severely reduces relapse rates and is cheaper than the hospitalisation that would happen if they relapsed; better for NHS
(-) Patients often have to pay at least partly for their own therapy which means it's not always accessible to everyone


Describe token economy systems as a psychological MANAGEMENT (NOT TREATMENT) of sch

- Based on operant conditioning; giving rewards to encourage desired beh
- Usually used for sch patients who've been sectioned in hospital for a long time and have dev.ed maladaptive beh.s e.g. poor hygiene, lack of motivation, not getting dressed etc
- They collect tokens (secondary reinforcers) which they can cash in for a prize (primary reinforcer) e.g. extra visits


Evaluate token economy systems as a psychological MANAGEMENT (NOT TREATMENT) of sch

(-) Little rehabilitative power once they've left hospital; no instant rewards like tokens in everyday life
(+) Ayllon and Azrin (1968) found that using token economies on female patients who'd been in hospital w/ sch for up to 16 yrs significantly increased their daily "normal" activities
(-) Gender biased; may not have the same effect for men
(+) Cheap and easy to carry out
(-) Unethical: suggested that token economies only actually exist to make staff's lives easier and not to help the patient