Psychological Treatments For SCZ

Question 1

Cognitive behaviour therapy

Answer 1

Aims to help patients identify irrational thoughts and challenge them - reality testing to reduce stress
• Therapists role is to challenge irrational beliefs: logically disrupting the reality of the delusions and helping to develop alternatives

Question 2

Ellis - ABC(DE) model

Answer 2

Understand the source of the faulty cognition and provide a process to cognitively restructure irrational belief
A - activating agent
B - belief
C - consequences
D - disrupting belief
E - effect: restructured belief

Question 3

Reality testing

Answer 3

Process by which the patient can demonstrate for themselves that their irrational thoughts are not real (symptom targeting)

Question 4

CBT - Evaluations

Answer 4

•SENSKY - patients after 19 sessions of CBT had reduction in positive and negative symptoms - continued to improve after 9 months
Suggests it can be effective when drug therapies are not and provide a long term reduction in symptoms

• Treatment requires engagement long-term. Patients with negative symptoms such as avolition may struggle with an unwillingness to take part

• Due to the severity of symptoms, some may not cope with vigorous confrontations of beliefs
Potentially brings up issues of lack of free will if patients thoughts are being altered and dictated by clinicians

Question 5

Family therapy

Answer 5

Range of intervention aimed at the entire family of a patient with SCZ
• Aims to improve the quality of communication and interaction between family members and reduce stress of living as a family
• Commonly used in conjunction with drug therapy and outpatient care

Question 6

Psychoeducation

Answer 6

Family is educated on the symptoms of SCZ in order for them to be more understanding of their behaviour and thought process
• reduce conflict
• reduce stress
• reduces relapse due to EE
• employment opportunities

Question 7

Family therapy evaluations

Answer 7

LEFT - outpatient care
• standard - 50% relapse
• family therapy - 8% relapse

Treatment requires long term engagement - patients with negative symptoms such as avolition may struggle with unwillingness to take part and families must be willing too

Question 8

Token economy

Answer 8

Form of behavioural therapy used to shape and manage behaviour so that patients in long stay hospitals are easier to manage
• involved desirable behaviours being encouraged through selective reinforcement
• rewards are given immediately as secondary reinforcers
• they can be swapped for more tangible rewards - primary reinforces
• this encourages desirable behaviours to be repeated because they have been associated with rewards and privileges

Question 9

Token economy evaluations

Answer 9

GLOWACKI - systemic review of 7 studies of effectiveness of token economies in managing chronic mental health conditions
• all studies: reduction in negative symptoms
• unwanted behaviours declined
• economies were effective across different institutional situations
• does not assess long term effectiveness

Potential ethical issues due to power imbalance and subjection to overly demanding tasks

GLOWAKCI- many studies lacked control groups which reduces the studies reliability