Psychological Therapy

Question 1

What is CBT?

Answer 1

-a method for treating mental disorders based on cognitive and behavioural techniques

Question 2

How can CBT help?

Answer 2

-make sense of irrational cognitions and how they impact feelings and behaviour
-understand where certain symptoms come from

Question 3

How does CBT help in auditory hallucinations?

Answer 3

-believe voices are true = afraid
-therapist convinces them that it comes from a malfunction of the speech centre
-cannot hurt them if they ignore it = less frightening
-makes it easier to cope with

Question 4

How does CBT help with hearing voices?

Answer 4

-convince them that it’s just an extension of ordinary experiences of thinking in words

Question 5

How does CBT help with delusions?

Answer 5

-can be challenged
-process of reality testing
-therapist and patient examine the likelihood that the beliefs are true
-tackle anxiety and depression

Question 6

What is family therapy?

Answer 6

-therapy carried out with all or some family members

Question 7

What is the aim of family therapy?

Answer 7

-to improve family communication and reducing the stress of living as a family

Question 8

What did Pharoah do?

Answer 8

-identified strategies to improve the functioning of a family that has a person with S

Question 9

How does family therapy help?

Answer 9

1. reduces negative symptoms
2. improves the family ability to help

Question 10

How does family therapy reduce negative symptoms?

Answer 10

-reduce levels of EE especially anger and guilt which usually results in stress
-reduces the likelihood of a relapse

Question 11

How does family therapy improve the families ability to help?

Answer 11

-encourages therapeutic alliance
-improves families beliefs about S
-ensures all members achieve a balance between caring and maintaining their own lives

Question 12

What are the 7 stages of the model of practice?

Answer 12

-Burbach
1. sharing basic info
2. offering emotional and practical support
3. identity resources of what each person can offer
4. mutual understanding
5. identify unhelpful patterns of interaction
6. stress management techniques
7. maintenance

Question 13

What did Gill do?

Answer 13

-meta-analysis
-found that family therapy reduced the chances of relapse within a year
-therapy improved compliance with taking medication
-effectiveness of family therapy may be indirect

Question 14

What research did Pharoah do?

Answer 14

-review of 53 studies to look at effectiveness of family intervention
-compared outcomes from FT to standard care
-focused on RCT’s

Question 15

What are RCT’s?

Answer 15

-randomised controlled trials
-people allocated at random to receive one of several clinical interventions

Question 16

What 4 findings did Pharoah find?

Answer 16

1. some reported improvement in mental state, some didn’t
2. using FT increased compliance with medication
3. general improvement in social functioning
4. reduction in the risk of relapse in 24 mths after therapy

Question 17

What do the findings of Pharoah suggest?

Answer 17

-family therapy is effective in improving clinical outcomes
-may have less to do with therapy and more to do with the increase of medication compliance

Question 18

What is supporting evidence to family therapy?

Answer 18

-Pharoah found that patients who completed FT were less likely to relapse
-suggests FT is important in reducing relapses rates

Question 19

What is a contradiction to family therapy?

Answer 19

-if patients are encouraged to comply with medication they would get similar results
-brings the effectiveness of FT into question

Question 20

What is an alternative to family therapy?

Answer 20

-drug therapy
-assumes there is a chemical imbalance and tries to correct it
-antipsychotics are effective at treating + and - symptoms of S and cogntive impairment
-Pharoah suggested that FT is only effective in compliance with drug therapy
-suggests drug therapy is important in alleviating S symptoms

Question 21

What evidence is there for economic benefits associated with the treatment of schizophrenia?

Answer 21

-NICE review of FT studies demo started that FT is associated with significant cost savings when offered along with standard care
-extra costs of FT is offset by the lower relapse rates for a significant period of time
-means that cost savings associated with FT would be even higher

Question 22

What is an issue and debate to family therapy?

Answer 22

-idiographic approach
-suggests everyone will similarly benefit from this treatment
-may not be true in all cultures
-further research must be done to see if FT would be as effective in cultures like China
-suggests a nomothetic approach would be better to use when considering treatments

Question 23

What did NICE find?

Answer 23

-CBT was effective in:
-reducing rehospitalisation for up to 18mths after
-reducing symptom severity
-improving social functioning

Question 24

How does CBT take place?

Answer 24

1. trace back to original symptoms to identify how they develop
2. evaluate context of delusions
3. set behavioural assignments to improve social functions
4. both develop own alternative to previous coping strategies

Question 25

How is the ABC model used in CBT?

Answer 25

A - explanation of activating events
B - trigger emotional beliefs and behavioural actions
C - consequences of B - rationalise and dispute them

Question 26

What is a strength of CBT for schizophrenia?

Answer 26

-its effectiveness
-Jauhar - reviewed studies using CBT - clear evidence for small effects on + and - symptoms
-clinical advice from NICE recommends CBT for schizophrenia
-means that research and clinical experience supports the benefits of CBT for S

Question 27

What is a limitation of CBT for schizophrenia?

Answer 27

-wide range of techniques and symptoms included in studies
-CBT techniques symptoms vary widely
-Thomas showed that different studies have involved the use of different CBT techniques
-overall modest benefits of CBT for S probably conceal a wide variety of effects
-makes it hard to say how effective CBT