Psychological Therapies for SZ: CBTp

Question 1

what are the psychological therapies for SZ

Answer 1

• Cognitive Behavioural Therapy (for psychosis)
• Family therapy

Question 2

Outline CBTp for SZ
- CBTp

Answer 2

Cognitive Behavioural Therapy for psychosis (or CBTp) = form of CBT given to SZ patients.

5-20 sessions; groups or individually.

Question 3

Outline CBTp for SZ
- assumption

Answer 3

Basic assumption: not events themselves that cause the person problems (activating events) but the belief they have about events.

Distorted beliefs -> negative effect on their feelings/behaviours (consequence)

Eg. someone with SZ may believe their behaviour is being controlled by something else.

Question 4

Outline CBTp for SZ
- process

Answer 4

CBTp is used to help the patient identify/correct faulty interpretations or beliefs.

Therapist/patient discuss how likely the irrational beliefs are to be true (reality testing) and consider other more rational beliefs (dispute)

allows the patient to make sense of how their delusions and hallucinations impact on their feelings and behaviour.

eg, if a patient hears voices and believes the voices are demons, they will naturally be afraid.

By thinking about rational, disputing beliefs -> feel ‘effect’ of challenging irrational thoughts -> less anxious -> positive effect on their behaviour.

‘ABCDE’ model.

Question 5

Evaluate CBTp for SZ
STRENGTHS

Answer 5

P) support for effectiveness from NICE (2014)
E) reviewed range of treatments for SZ
E) CBTp far more effective than antipsychotic drug therapy, in reducing symptom serererty and improving cognitive functioning.
L) CBTp is a useful and effective treatment for SZ

P) more appropriate than drug therapy
E) psychological therapies (FT and CBT) can be easily adapted to
the needs of individual patients and families (idiographic approach) unlike biological therapies eg. drugs which treat every sufferer in a similar way (a nomothetic approach).
L) more appropriate therapies due to vast individual differences between sufferers.

P) more appropriate than drug therapy: no side effects

Question 6

Evaluate CBTp for SZ
LIMITATIONS

Answer 6

P) effectiveness may be overstated
E) most studies of effectiveness conducted with patients treated with antipsychotics at the same time
E) recent research: CBTp as a sole treatment for SZ may be less effective than originally thought
L) difficult to assess effectiveness independent of antipsychotic medication

P) effectiveness may depend on stage of the disorder
E) CBTp may be more effective when it is made available at specific stages of the disorder.
E) Addington and Addington (2005): in initial phase of SZ, self-reflection on symptoms is not particularly appropriate. But, after stabilisation of symptoms with antipsychotic medication, individuals can benefit from group-based CBT which can help normalise their experience by meeting other individuals with similar issues.
L) CBT only useful for specific stages of treatment; must be constantly adapted.

P) psychological therapies only address the symptoms not causes. E) eg. argued that SZ has a biological cause eg. dopamine imbalance
E) family therapy/CBTp only combat symptoms (course of SZ) rather than its underlying cause
L) limited short term solution; only appropriate to use in conjunction with biological therapies eg drugs

P) negative effect on economy, less cost effective/impractical compared to drugs

P) less appropriate due to effort required from patients; drug therapy may hinder engagement eg sedation