psychological therapies

Question 1

What is CBT

Answer 1

Method for treating mental disorders - based on cognitive and behavioural approach

Question 2

Aim of CBT

Answer 2

Deal with thinking of the patient - such as challenging negative thoughts
- Identify and challenge irrational thinking

Question 3

Outline stages of coping strategy enhancement

Answer 3

1. Initial assessment - behaviour analysis and assessment of coping strategies
2. Help with dysfunction in metarepresentation
3. Education and rapport training - coping strategies enhanced
4. Symptom targeting

Question 4

How does CBT help

Answer 4

helps with dysfunction in central control as they learn to block out their automatic negative thoughts through copying strategies
- Shows clients how delusions and hallucinations affect their feelings and behaviour
- Reality testing

Question 5

Case study

Answer 5

Turkington et al
- Thinks mafia observing how to kill and asks if the therapist thinks its mafia
- Therapist says possibility but other explanations - how do you know it’s the mafia

Question 6

EVAL - Evidence of effectiveness - CBT

Answer 6

strength as research to show effectiveness
E - Jauhar et al - analysis of 34 studies of CBT with schizophrenia, clinical advice from NICE
E - clear evidence for small but significant effects on both positive and negative symptoms, reductions in frequency and severity of auditory hallucinations, NICE recommends CBT for schizophrenia
L - both research and clinical experience support the benefits of CBT for schizophrenia

Question 7

EVAL - quality of evidence - CBT

Answer 7

limited as there is a wide range of techniques and symptoms included in the studies
E - Thomas - different studies involved different CBT techniques - people with different combinations of positive and negative symptoms
E - individual differences - CBT techniques and symptoms vary widely - overall modest benefits of CBT for schizophrenia probably conceal a wide variety of effects of different CBT techniques on different symptoms
L - effectiveness is different for different people - hard to say how effective CBT will be for a particular person with schizophrenia

Question 8

EVAL - Does CBT cure?

Answer 8

P - CBT is associated with the improvement of the quality of life for those with schizophrenia
E - limited by the fact that CBT does not provide a cure - due to biological links with the condition such as dopamine hypothesis - psychological therapy just benefits people by improving their ability to live with schizophrenia
E - however, studies report significant reductions in severity of symptoms (negative and positive)
L - CBT is able to aid in symptoms showing it does more than simply enhancing coping strategies

Question 9

What is family therapy

Answer 9

A form of psychological therapy - involves all or some members of a family

Question 10

Aim of family therapy

Answer 10

Improving the communications within the family and reducing the stress of living as a family

Question 11

How does family therapy help

Answer 11

Pharoah et al - identify a range of strategies that family therapists use to try to improve the functioning of a family such as reducing negative emotions and improving family’s ability to help

Question 12

Reducing negative emotions

Answer 12

Reduces expressed emotion eg anger and guilt which create stress
- Reduces likelihood of relapse

Question 13

Improving the family’s ability to help

Answer 13

• Form therapeutic alliances, improving beliefs towards schizophrenia, achieving balance between caring for individual and maintaining their own lives

Question 14

model of practice

Answer 14

Burbach - seven phases
1. Share basic information and provide emotional and practical support
2. Identifying resources including what different family members can and cannot offer
3. Aims to encourage mutual understanding - safe space
4. Involves identifying unhelpful patterns
5. Skill training
6. Relapse prevention training
7. Maintenance for future

Question 15

EVAL - Evidence of effectiveness - family

Answer 15

P - strength as there is evidence that shows it’s effectiveness
E - Review of studies from McFarlance, NICE
E - family therapy - one of most consistently effective treatments - relapse rate reduced (usually 50-60%) - NICE recommends family therapy for everyone with a schizophrenia diagnosis
L - family therapy is likely to be of benefit to people with both early and full-blown schizophrenia

Question 16

EVAL - benefit to whole family

Answer 16

P - strength as benefits all family members
E - Lobban and Barrowclough - effects are important because families provide the bulk of care for people with schizophrenia
E - strengthens functioning of whole family - lessens negative impact of schizophrenia on other family members and strengthens the ability of family to support the person with schizophrenia
L - means family therapy - winder benefits

Question 17

EVAL - Which matters most?

Answer 17

P - argued to be cost-effective - economic benefits
E - this is due to family therapy reduces relapse rates and makes families better able to provide the bulk of care it has huge economic benefits - the state does not need to pay so much
E - however, not just economic benefits - family therapy also has very significant therapeutic benefits for people with schizophrenia and families
L - family therapy has both economic and therapeutic benefits - but which is primary use