Psychological Treatments - CBT

Question 1

How does it work?

Answer 1

• Takes place over period of 5-20 sessions, either in groups or on an individual basis
• It aims to deal with both thoughts (cognitions) and behaviour

Question 2

How It Helps (Part 1)

Answer 2

• CBT can help a client make sense of how their irrational cognitions (delusions, hallucinations, etc) impact their feelings and behaviour
• Just understanding where symptoms come from can be hugely helpful for those with symptoms like auditory hallucinations
• If a therapist can convince someone that the voice/s they hear come from the malfunctioning speech centre of their brain and that they can’t be hurt if they ignore them, this is much less frightening and less debilitating
• This won’t eliminate symptoms but can make people better able to cope with them, which can reduce distress and improve ability to function adequately

Question 3

How It Helps (Part 2)

Answer 3

• People hearing voices can also be helped by teaching them that voice-hearing is an extension of the ordinary experience of thinking in words (normalisation)
• Delusions can also be challenged for example by a process of reality testing in which the person with schizophrenia and their therapist jointly examine the likelihood that beliefs are true
• In cases where delusions are resistant to reality testing, CBT can still be used to tackle the anxiety and depression that result from living with schizophrenia

Question 4

Evaluation - Evidence for effectiveness

Answer 4

• Jauhar et al (2014) reviewed 34 studies of using CBT with schizophrenia, concluding that there is clear evidence for small but significant effects on both positive and negative symptoms
• Other studies have focused on symptoms - Pontillo et al (2016) found reductions in frequency and severity of auditory hallucinations
• Clinical advice from NICE (2019), the National Institute for Health and Care Excellence, recommends CBT for schizophrenia
• This means that both research and clinical experience support the benefits of CBT

Question 5

Evaluation - Wide range of techniques and symptoms included in studies

Answer 5

• Thomas (2015) points out that different studies have involved the use of different CBT techniques and people with different combinations of positive and negative symptoms
• The overall modest benefits of CBT for schizophrenia probably conceal a wide variety of effects of different CBT techniques on different symptoms
• It’s hard to say how effective CBT will be for a particular person with schizophrenia