cognitive behavioural therapy

Question 1

what is CBT?

Answer 1

• based on the idea that sz patients can be helped by identifying and changing their faulty cognitions which influence their behaviour
• it aims to change maladaptive thinking and distorted perceptions which underpin the disorder, to modify and improve their symptoms
• those with sz are offered CBTp

Question 2

what is the process of CBTp?

Answer 2

1. once every 10 days for 12-16 sessions, usually one to one but can be done in groups
2. aims to establish links between their thoughts, feelings, actions and their symptoms and functioning. this allows them to consider alt ways to explain their feelings and actions. also taught to recognise signs of relapse
3. use drawing to display links between thoughts, feelings and actions
4. develop cognitive techniques like distractions, challenging thoughts, increasing/decreasing social activity, relaxation techniques
5. the patient takes an active role and is given homework

Question 3

give a strength of CBT
1/4

Answer 3

research shows that those who have CBTp suffer from fewer hallucinations and delusions and recover more than those who just receive meds. drury et al (1996) found a 25-50% recovery time reduction in those given both meds and CBTp. demonstrates that those given CBTp alongside drugs make more rapid improvements

Question 4

give a strength of CBT
2/4

Answer 4

CBTp combined with drugs has many benefits. tarrier et al (2000) found those who had 20 CBTp one-to-one sessions with drugs, then 4 booster sessions during the year made better improvements than those having one of these alone. kuipers et al (1997) also found patients had a lower drop out rate and higher satisfaction when having both. this shows that when both are used together, they become more effective

COUNTER = however since they are used together, it’s hard to distinguish if it is a combination of the treatments or CBT alone that causes the improvements

Question 5

give a strength of CBT
3/4

Answer 5

it works for those who don’t respond to other treatments. sensky et al (2000) found that CBT was effective in treating those who didn’t response to drug treatments, and these continued to improve 9 months after treatment ended. this shows CBTp is effective for drug-resistant patients and that it has long-lasting positive effects

Question 6

give a strength of CBT
4/4

Answer 6

it has less side effects than drugs (e.g. they’re not at risk of issues like tardive dyskinesia or diabetes)

however, CBTp is more expensive, which may explain why it isn’t always readily available (in the UK 1 in 10 are offered it). the economic implications of this is that although CBTp is more expensive initially, it can save the NHS money from patients not needing the further intervention they would with drugs

Question 7

give a limitation of CBT
1/2

Answer 7

many psychiatrists say patients don’t benefit from CBTp and that it isn’t appropriate for everyone. kingdom et al (2006) stated of 142 patients there were many not suitable for CBT as they wouldn’t fully engage with it, they also found that older patients were less suitable. it may be that CBT isn’t suitable for patients who are too disoriented, agitated or paranoid to form relationships with the therapist, it would be difficult to do CBTp effectively with them.

Question 8

give a limitation of CBT
2/2

Answer 8

research into CBT effectiveness is criticised. jauhar et al (2014) did a meta-analysis of 50 studies of CBT for sz and found only a small therapeutic effect on symptoms, and this small effect disappeared when studies used blind testing (where researchers don’t know who was given CBT). meta-analysis is regularly used to test effectiveness but blind testing isn’t often used in CBT research, which questions the research’s validity.