Psychological Treatments For Schizophrenia Flashcards
(15 cards)
CBT: intro to
- distorted beliefs negatively influence feelings and behaviour. Delusions result from faulty interpretations of events.
- 5-20 sessions one on one or group
- patients are encouraged to evaluate content of their delusions/voices to test validity of
beliefs, THEN change them. - Patients helped to make sense of how their delusions/hallucinations impact on their feelings and behaviour.
- Distorted thinking and maladaptive beliefs are identified with the help of the therapists, looking for alternative explanations and coping strategies.
CBT: assessment
Patient expresses their thoughts/goals using distress as motivation for change.
CBT: Engagement
The therapist empathised with patient’s perspective and stress.
Ellis’ ABCD model:
Activating event (voices)
Beliefs (voices are mean and hostile)
Consequence emotional. (sorrow, depression) are discussed.
Disputed (irrational beliefs are disputed)
CBT: normalisation
Patients are assured that many people have hallucinations/delusions when they are stressed, this reduces patients anxiety around symptoms and helps strengthen belief in recovery.
CBT: CCA (critical collaborative analysis)
The therapist uses gentle questioning to challenge the patients beliefs, in an atmosphere of trust and non-judgemental acceptance.
CBT: developing alternative explanations
the patient develops their own alternative explanations for previously unhealthy assumptions, with the support of the therapist.
AENCD
Always (assessment)
Eat (engagement)
New (normalisation)
cucumber (critical collaborative analysis)
Daily (developing alternative explanations
)
Turkington et al (2004) case example
- treated a paranoid client who believed the Mafia were plotting to kill him
The therapist acknowledged the client’s anxiety, and explained that there were other, less frightening possibilities and gently challenged the client’s evidence for his belief in the Mafia explanation.
+ AO3 strengths for CBT
+ Pontillo et al (2016): found reductions in auditory hallucinations.
+ Jauhar et al (2014) reviewed results of 34 studies for CBT use for schizophrenia and concluded that CBT has a small effect on both positive and negative symptoms reduction.
- AO3 weaknesses for CBT
- CBT Lack of availability of CBT: only 1 in 10 patients who could benefit are able to access CBTp in the UK BUT some refuse treatment or fail to attend. CBT has homework meaning it relies on people to take initiative outside of their sessions for it to be effective. This also means it’s not suitable for all patients as those with extreme agitation and delusions won’t be able to rationalise with a therapist.
- CBT helps patients make sense of their symptoms, BUT does not cure. Biological therapies do not cure schizophrenia BUT DO reduce the severity of symptoms and therefore a combination may be be more desirable at understanding and treating .
- CBT is also very expensive and hard to access due to a lack of it and it’s expense.
Family therapy introduction
- aims to eliminate or at least reduce destructive emotions such as anger, guilt, shame which can affect family dynamic and the schizophrenia sufferer.
- reduce levels of expressed emotion which reduces risk of relapse.
How does family therapy work?
- reduces expressed emotions of anger and guilt by family members.
- enables everyone to have a voice and the best way to help an ex schizophrenic to reduce family tension.
- enhances relatives ability to support and problem solve, as well as understanding the illness better.
Burbach’s model of family therapy
Phases 1 and 2: share information and identify resources family can offer.
Phases 3 and 4: learn mutual understanding, and look at unhelpful patterns of interaction
Phases 5, 6 and 7: skills training (e.g. stress management techniques), relapse prevention and maintenance
+ AO3 strengths
+ therapy is not just for the benefit of the patient but also the families that provide the majority of the care for the person with Sz. Family therapy lessens the negative impact of Sz on the family and strengthens the ability of the family to give appropriate support. This means relapse rate is reduced as understanding is mutual and talked about.
- AO3 weaknesses
- If a patient has a good standard of care, in a family with relatively low expressed emotions, then family therapy may give no further advantages.
- requires patients and parents to be cooperative and open-minded for therapy to be effective, therefore it is not an appropriate treatment in all cases.
