Schizophrenia Flashcards

Question

Evaluation of CBTp.

Answer 1

strength (counter); research support. NICE (2014) found it was effective in reducing hospitalization, suggests there are alternative ways of dealing with schiz. However, most studies looking at effectiveness of CBTp have been done in conjunction with drugs. It is difficult to assess what is actually having the impact, weather CBTp is working independently. Thus limiting the effectiveness of CBTp to treat schiz. limitation; not always appropriate. Appears to be more effective at certain stages of schiz and when the therapy is adjusted to the individual. Although beneficial for some schiz patients, its not for everyone, meaning it cannot be generalised to all patients to have the same effect. limiting it's effectiveness limitation; lacks accessibility. Haddock (2013)- 187 patients, only 13% had access to CBTp. TMB not everyone suffering are able to benefit from it due to lack of access, they will continue to struggle and not be able to be treated. limiting CBTp as a way of treating schiz. limitation; benefits of it may be overstated. Jaunar (2014), only small therapeutic on symptoms like hallucinations and delusions- this has lead to conflicting recommendations form psychologists- even in the UK. TMB isn't a definitive set of instructions- psychologists are left to their own devices on how to help patients, which may not always be the correct decision, not actually helping them. limiting use.

Answer 2

FAMILY THERAPY; provides support for carers in an attempt to make life less stressful, reduces neg emotions and increases families ability to help. - 3-12 months recommended - schiz individual encouraged to be there as much as possible but sessions can take place without them REDUCES NEGATIVE EMOTIONS - like anger and guilt, removing these reduces chances of relapse IMPROVES FAMILIES ABILITIES TO HELP - encourages family to form a therapeutic alliance, therapist tries to improve families beliefs about schiz. - try to help achieve a balance between maintaining own life and helping the person with schiz.

Answer 3

1. sharing basic info & providing practical and emotional support 2. identifying resources 3. aims to encourage a mutual understanding, safe space for all members to express 4. identifying unhelpful patterns of interactions 5. learning stress management techniques 6. relapse prevention planning 7. maintenance for the future

Answer 4

strength; economic benefits, NCCMH (2009) found significant cost savings when family therapy was combined with antipsychotics. Originally adds to expenses, but in long run it reduces rehospitalization and relapse rates, reduces cost for care providers. Supporting family therapy. limitation; limited effect of family therapy when combined with drugs. Pharoah (2010) found that family functioning only had a little effect on relapse rates, instead it encouraged patients to take their medication. TMB shows that antipsychotics are actually the reason to the decrease of symptoms and relapse. Thus limiting use of family therapy. limitation; only helps manage symptoms not cure them. Family therapy only helps subside symptoms but does not get rid of them. FT alone cannot be used to treat schiz and it requires something alongside it. Limiting use. limitation; Reductionist. Based on premise that schiz is result of nurture. Biological basis in schiz is not addressed in FT. TMB there is evidence to show that schiz symptoms are a result of chemical imbalances, ignoring this, symptoms are not being cured, patient does not benefit as much as if FT was used in conjunction with drug therapy. Limiting effectiveness.

Answer 5

TOKEN ECONOMIES - behaviourist approach to management of schiz - aimed at targeting neg symptoms - used for long-term hospitalized patients. HOW IT WORKS - clinicians set target behaviours that improves social functioning in everyday life - tokens awarded for each desirable behaviour displayed (can be exchanged later for rewards) - tokens act as a neutral stimulus (to give it value, reward must be presented alongside/ immediately after token) - reinforcing value - as a result of this classical conditioning, tokens become secondary reinforcers- can be used to manage schiz behaviours (effectiveness of TE may decrease if more time passes between the presentation of token and exchange for reward)

Answer 6

strength; research support- Allyon & Azrin (1968)- female schiz patients using TE increased desirable behaviours each day. TMB it highlights that TE is effective, demonstrated by the association of reward and desirable behaviours, helps return to normal functioning. Strengthening use of TE as a way of managing schiz. limitation; difficult to assess effectiveness of treatment. Comer (2013) found when TE was brought into the ward, all patients are introduced to it rather than having a control group who isn't. TMB this would allow researchers to rule out alternative explanations for the behaviour and ensure the TE is responsible. Limiting use. limitation; ethical issue concerns. To make reinforcement effective, researchers must exercise control over 'human rights' like privacy or food. TMB TE could be considered dehumanizing and may have negative effect on patient. Patient relatives may also dislike treatment so choose to withdraw them from it, increasing relapse rates. Limiting use. limitation; may only be effective in a institutionalized setting. Patients receive 24hr care- monitored and rewarded appropriately. However, out patient schizophrenics are only see for a few hours a day. TMB outpatients will not have anyone to monitor them or reward them for their behaviour, this means that association is lost, TE looses effectiveness. Suggests TE lacks eco validity as not effective in real world (outside of institution). Limiting use.

Answer 7

DIATHESIS STRESS MODEL - sees schiz as a result of interaction between biological (diathesis) & environmental (stress) influences. - minor stressors may lead to onset of schiz for an individual who is highly vulnerable. DIATHESIS (genes) - family studies suggest that people have varying levels of inherited genetic vulnerability , childhood trauma can trigger schiz. Reed- childhood trauma causes HPA to become overreactive- more vulnerable to stress. STRESS (env) - research shows children who experienced trauma before age 16 were vulnerable to schiz. New diathesis stress model considers use of cannabis.

Answer 8

strength; research support- Barlow & Durana (2009), found that a family history (genetic link) combined with a dysfunctional family increased the risk of developing schiz. TMB it supports the diathesis-stress model as the increased risk was due to combination of genetic factors and env factors. Supporting interactionist approach to explaining schiz. limitation; individual differences. Diathesis-stress model proposes that schiz is caused by a combo of biology & env. However, it is not known precisely how these contribute to the model. TMB suggests that the approach is limited as we do not fully understand the mechanism by which illness develops and how both vulnerability and stress produce it. Limiting explanation of interactionist approach. limitation; too simplistic, unlikely that a single gene combined with a poor parenting style causes schiz. Multiple genes have been found to increase the risk of developing schiz, indicating there is no single 'schizogene' and stress is not limited to parenting style. TMB suggests that proposing vulnerability and stress have one single cause and each come in one form, like original model suggests, it is over simplistic and dated.

Answer 9

GUO (2010) - suggests combining bio + psych is more effective - difficult to state which combo is more effective by each persons circumstances (no point in combining drug therapy with family therapy if patient has no contact with relatives) TURKINGTON (2006) - psychological treatment never usually given on it's own - Britain offers drug therapy first- assesses the situation and later implements CBTp

Answer 10

strength; combining treatments is cost-effective. Schiz has bio + psych components, initial cost is more expensive- as effectiveness increases the likelihood of relapse and rehospitalization decreases making it more cost-effective. thus benefitting the patient and the economy due to expenses. Strengthening use of interactionist approach to treat schiz. strength; research support- Guo (2010)- found patients who received combo treatment whilst in early stages of schiz had improved insight & social functioning, less likely to relapse. TMB shows value for patients of combining bio + psych treatments, by reducing cognitive symptoms and helping them to return to normal functioning. Validating interactionist approach. limitation; combining treatments does not always have a pos impact. Patients receiving CBT can sometimes interpret antipsychotic side effects in a delusional manner. TMB can lead them to mistrusting & resisting any further treatment, making them vulnerable to relapse. Combining treatments can cause further issues, limiting use of interactionist approach to treat schiz.

Schizophrenia Flashcards

(34 cards)