Psychological therapy Flashcards
(16 cards)
What is CBT?
Cognitive behavioural therapy
Period of 5-20 sessions
Groups or on individual basis
Deals with both thoughts and behaviours
How does CBT help?
Helps client make sense of how their irrational cognitions impact on their feelings and behaviour
Understanding where symptoms come from can be helpful for those with symptoms like auditory hallucinations
Eg. if therapist can convince then voice actually comes from malfunctioning speech centre in their own brain nd cannot hurt them if they ignore it - much less frightening and hence less debilitating
Will not eliminate symptoms but can make easier to cope
Reduces distress and improves ability to function adequately
How can people be helped with hearing voices using CBT?
Helped by teaching them that voice-hearing is an extension of the ordinary experience of thinking words
Normalisation
How can delusions be challenged using CBT?
Process of reality testing - person with schizophrenia and their therapist jointly examine likelihood that beliefs are true
In cases where it can be resistant to reality testing
CBT used to tackle anxiety and depression
What was Turkington et al’s case example of CBT?
Challenge where paranoid clients delusions come from
PC - the mafia are observing me to decide how to kill me
T - You are obviously very frightened… there must be good reason for this
PC - Do you think its the mafia
T - Its a posibility but there could be other explanations, how do you know that its the mafia?
What is a strength of CBT?
Evidence of effectiveness
Jauhar et al
34 studies of using CBT with schizophrenia
There is clear evidence for small but significant effects on both positive and negative symptoms
Pontillo et al
Reductions in frequency and severity of auditory hallucinations
National institute for health and care excellence - recommends CBT
Both research and clinical experience support benefits of CBT for schiz
What is a limitation of CBT?
Wide range of techniques and symptoms included in studies
Vary widely from one case to another
Thomas
Different studies involved the use of different CBT techniques - people with different combinations of positive and negative symptoms
Overall modest benefits of CBT probably conceal a wide variety of effects of different CBT techniques on different symptoms
Making it hard to say how effective CBT will be for particular person with schiz
What is family therapy?
Takes place with families as well as identified patient
Aims to improve quality of communication and interaction between family members
Range of approaches to family therapy for schizophrenia
Who talks about family therapy?
Pharoah et al
How does family therapy help?
Pharoah et al identified range of strategies that family therapists use to try to improve functioning of a family that has a member with schizophrenia
How does family therapy reduce negative symptoms?
Aims to reduce levels of expressed emotion
ie. Reduce the level of emotion generally but especially negative emotions like anger and guilt which create stress
Reducing stress important to reduce the likelihood of relapse
How does family therapy help improve ability to help ?
Therapist encourages family members to form a therapeutic alliance - all agree on aims of therapy
Therapists also try to improve families beliefs about and behaviour towards schizophrenia
Ensure family members achieve a balance between caring for individual with schizophrenia and maintaining their own lives
Who proposed a model of practice for family therapies?
Burbach
What is the model of practice for families?
Sharing basic info and providing emotional and practical support
Develops through progressively deeper levels
Phase 2 - identifying resources including what different family members can and cannot offer
Phase 3 - Encourage mutual understanding, creating safe space for all family members to express their feelings
Phases 4 - Identifying unhelpful patterns of interaction
Phase 5 - Skills training, eg learning stress management techniques
Phase 6 - Relapse preventions planning
Phase 7 - Maintenance for the future
What is a strength for family therapy?
Evidence of effectiveness
McFarlane
Family therapy one of the most consistently effective treatments available for schizophrenia
Relapse rates were found to be reduced - typically 50-60%
Mental health initially starts to decline
Clinical advice from NICE recommends family therapy for everyone with a diagnosis of schiz
Meaning family therapy is likely to be of benefit to people with both early and full blown schizophrenia
What is a strength of family therapy?
Benefits whole family
Lobban et al
These effects are important because families provide the bulk of care for people with schiz
By strengthening functioning of whole family - lessens the negative impact on other family memebers and strengthens ability of family to support person with schiz
Meaning has wider benefits beyond the obvious positive impact on the identified patient
