Cognitive behavioural therapy Flashcards
(13 cards)
What is the purpose of CBTp?
Help patient identify and correct these faulty interpretations of events
Help people establish links between their thoughts, feelings or actions and their symptoms and general level of functioning = patients are better able to consider alternative ways of explaining why they feel and behave in the way they do - reduces distress and improves functioning
How many sessions of CBTp do NICE recommend?
16
What is the nature of CBTp?
Patients encouraged to trace back the origins of their symptoms to get a better idea of how they developed + to consider ways to test the validity of their faulty beliefs
- Might be set behavioural assignments to improve general functioning
- Therapist lets the patient develop their own alternatives to previously maladaptive beliefs, ideally looking for alternative explanations/coping strategies
What are the processes involved in CBTp?
Assessment
Engagement
ABC model
Normalisation
Critical collaborative analysis
Developing alternative explanations
What is involved in the assessment stage?
Patient expresses thoughts/feelings
Realistic goals for therapy are discussed
What is involved in the engagement stage?
Therapist empathises with patient and stresses explanations for their distress can be developed together
What is involved in the ABC model stage?
Patient gives explanation of activating events that instilled beliefs and their consequences. These can then be rationalised, disrupted and changed
What is involved in the normalisation stage?
informations that many people have unusual experiences - reduces anxiety and sense of isolation (less alienated and stigmatised)
What is involved in the critical analysis stage?
Therapist uses gentle questioning to help the patient understand illogical deductions and conclusions e.g. “if your voices are real, why can’t others hear them?”
Such questions can only be asked once there is an atmosphere of trust between the patient and therapist (who remains empathetic and non-judgemental)
What is involved in the developing alternatives stage?
Patient develops own alternative explanations for their previously unhealthy assumptions - new ideas can be constructed in cooperation with the therapist
What evidence is there for the effectiveness of CBTp?
The NICE review of treatments found consistent evidence that when compared standard care alone CBTp was effective in reducing rehospitalisation
Also effective in reducing symptom severity and social functioning
However, most studies have been conducted with patients on antipsychotics- difficult therefore to assess the effectiveness of CBTp independent of medication
Why is lack of availability an issue with CBTp?
Only 1/10 who could benefit get access to this form of therapy
Haddock et al - in the North West of England found that out of 187 randomly selected patients, on 13 had been offered CBTp
+ those who do get offered often refuse or fail to attend sessions - limiting its effectiveness
Why may the benefits of CBTp have been overstated?
Jauhar et al - large scale meta-analysis revealed only a ‘small’ therapeutic effect on the key symptoms however even these small effects disappeared when symptoms were assessed ‘blind’
Is it really effective?
