Psychological Therapies for SZ

Question 1

What is CBT?

Answer 1

Main psychological treatment

Question 2

Assumption behind CBT

Answer 2

Disordered beliefs influence behaviour in maladaptive ways, leading to SZ

Question 3

Aim of CBT

Answer 3

Help patient identify these faulty/disordered beliefs and correct them

Question 4

What are patients encouraged to do in CBT?

Answer 4

• Trace origins of symptoms & when first arose
• Evaluate content of delusions/internal voices
• Behavioural assignments

Question 5

What might patients evaluating the content of delusions/voices lead to?

Answer 5

Consider ways they could test the validity

Question 6

What might behavioural assignments lead to?

Answer 6

Improved levels of functioning

Question 7

What is a final stage of CBT?

Answer 7

Therapist lets patient develop own alternatives to maladaptive belief
Looks for alternative explanations/coping strategies already present

Question 8

What do outcome studies do?

Answer 8

Measure effectiveness of treatments in comparison to accepted, standard form of treatment

Question 9

What have outcome studies suggested about CBT

Answer 9

Patients recover to far greater extent

Question 10

What did Dury find regarding outcome studies of CBT

Answer 10

20-25% reduction in recovery time when combined with APs

Reduction in positive symptoms

Question 11

What did Kuipers find in a subsequent study regarding CBT outcome studies?

Answer 11

Same advantages with lower patient drop out rate and increased satisfaction

Question 12

What are the AO1 points?

Answer 12

CBT
Outcome Studies
Psychodynamic Therapy

Question 13

AO2 Research for CBT?

Answer 13

Generally shows CBT has significant effect on improving symptoms
Gould - meta analysis of 8 - statistically significant decrease in positive symptoms post CBT

Question 14

AO2 Why might CBT benefits not be due to CBT alone?

Answer 14

Majority of students have been conducted whilst patients are undergoing APs treatment

Question 15

Many CBT studies have taken place while patients are on Aps also. What does this mean?

Answer 15

Difficult to assess CBT as independent treatment

Question 16

Although it is difficult to assess CBT as an independent treatment, what does it support?

Answer 16

• Success when used with APs

- Supports a bio-psycho interaction

Question 17

Rather than eliminating them entirely, how does CBT work?

Answer 17

Reducing distressing symptoms of psychotic experiences

Question 18

Why might negative symptoms be useful?

Answer 18

Safety behaviours - rapid treatment/hospitalisation

Question 19

What does encouraging reduction of distressing symptoms mean for patients?

Answer 19

Forced to mask rather than experience with any less vigour

Question 20

What concerns are there for CBT regarding its appropriateness?

Answer 20

Ethical - suffering in silence?

Question 21

What is an issue with the appropriateness of CBT regarding its approach?

Answer 21

Reductionist as oversimplifies to simply cognitive explanation when there are bio roles

Question 22

CBT in conjunction with…

Answer 22

APs has widely seen benefits

Question 23

Does everybody with SZ benefit from CBT?

Answer 23

No

Question 24

Who benefits from CBT? Study -

Answer 24

142 SZ patients - found CBT may not be suitable as may not fully engage with therapy

Question 25

Why might some not fully engage with CBT therapy?

Answer 25

- Some may lack intelligence | - May only work with milder forms

Question 26

Why might CBT only work with milder sZ forms?

Answer 26

Symptoms are too severe, mind too chaotic

Question 27

What is psychoanalysis based on?

Answer 27

Assumption that individuals are often unaware of the influence of unconscious conflicts on their psychological state

Question 28

What is the aim of psychoanalysis?

Answer 28

Bring conflicts into the conscious mind so they can be attended to

Question 29

What does psychoanalysis assume about symptoms?

Answer 29

All are meaningful and product of individuals life history

Question 30

What happens in psychoanalysis?

Answer 30

- Alliance created by help offered to perceived problems - Trust of patient won and relationship built by therapist replacing the harsh, punishing conscience with more supportive conscience

Question 31

Why did Freud oppose techniques such as PA?

Answer 31

SZ patients could not be analysed as could not form a transference (shift of emotions onto analyst)

Question 32

What resulted from Freud's pessimism towards PA?

Answer 32

Only a handful practice this technique or variations

Question 33

Effectiveness of PDA - What did Malmberg/Fenton find?

Answer 33

We cannot draw definite conclusions about effectiveness (subjective) - Some may argue PDA is harmful

Question 34

Effectiveness of PDA - What did Meta analysis find?

Answer 34

- MA of 37 studies | - Effective treatment in psychotherapies, amplified when used in conjunction with APs

Question 35

Contradictory effectiveness of PDA: What was found regarding APs?

Answer 35

- better outcome when PDA/Aps combined - APS superior compared to PSD alone - Just AP, not PSD?

Question 36

Contradictory effectiveness of PDA: What did Karen and VandenBos find?

Answer 36

- Opposite findings | - Patients treated with PDA improved more than APs alone

Question 37

Why might PDA be appropriate for patients?

Answer 37

- APA recommend supportive interventions alongside APs | - PDA is undoubtedly supportive

Question 38

What is an argument opposing PDA regarding the cost?

Answer 38

- Expensive | - Treatment required to be undergone long term

Question 39

What is an argument opposing PDA regarding the cost in relation to APs?

Answer 39

Not worth extra expense, as APs are cheaper and more effective

Question 40

What is an argument in SUPPORT of PDA over APs regarding cost?

Answer 40

- Overall cost may decrease as less likely to seek inpatient treatment if they get better over time - Employment?

Question 41

Overall, what do suggestions into cost and benefits of PDA show?

Answer 41

May be reliant upon individual and their level of functioning