Schizophrenia: Social Treatments - Assertive Community Therapy Flashcards
(13 cards)
What social theory explains a cause for schizophrenia?
Social Causation Hypothesis
What does the social theory say about the cause of schizophrenia?
That it is triggered by factors from the environment such as social adversity, immigration, and family relations.
Who is this therapy mostly used by?
The community and people with mental health disorders that cannot function on their own.
Describe how assertive community therapy is carried out.
- A team of staff (often psychiatrists) share a caseload of one person
- There is a high frequency of patient contact with a 10:1 staff to patient ratio- allows for an intensive, individualised support.
- Services are available 24 hours a day, helping to reduce hospital admissions when in need of crisis support.
- Individualised support focused on independence and recovery
- Offer support with daily activities (more holistic support)
- Treatment of patient in real life setting
- there is a continuity of care- the same team stays with a person long-term, fostering trust and strong therapeutic relationships.
Give 3 examples of how ACT would help someone.
1) Banking
2) Shopping
3) Laundry
Different treatment method and CA
An alternative treatment method is drug therapy. (Describe drug therapy). ACT involves someone helping a patient to improve their independence and functioning to reduce relapse rates longer term, whereas antipsychotics are a faster way of reducing symptoms to allow the patient to return to normal life so they may be more committed to this method. However, antipsychotics such as clozapine have negative side effects such as…, whereas ACT has no side effects. This provides more of a motivation for the patient to continue with ACT as the no side effects and overall more personalised, relationship based treatment makes people less likely to disengage from the treatment compared to medication only approaches, leading to lower relapse rates and overall higher efficacy levels.
Using the acronym ‘DESSERT’, evaluate an ‘expense’ point.
A weakness of ACT is that it is not available to everyone as this can be expensive. Paying for many psychiatrists to take care of you and be available 24/7 would be expensive and need a lot of Government funding and it is also only available in urban areas with high pop density. Therefore it may not be available to people who need it most as can’t afford or don’t live in urban areas, reducing its efficacy as an overall treatment for sz patients.
Supporting study for the effectiveness of act
A strength is the supporting evidence from Bond et al. (2000), who summarised 25 studies that looked at the effectiveness of ACT that compared to standard community care, it was highly effective due to engaging clients and preventing re-hospitalisation. Therefore, this supports the effectiveness of ACT in the treatment of sz.
Strength (side effects).
A strength of ACT is that there are no side effects of ACT. This provides more of a motivation for the patient to continue with ACT as the no side effects and overall more personalised, relationship based treatment makes people less likely to disengage from the treatment compared to medication only approaches, leading to lower relapse rates and overall higher efficacy levels. However, it is often needed to be paired with medication if symptoms are bad enough and so patients will experience negative side effects from this anyway, such as tardive dyskinesia. Therefore some may not seek extra therapy (that wouldn’t reduce side effects) to aid them if they are already receiving one.
An ethical issue of ACT
A weakness of ACT as a treatment for sz is that there is High levels of social control. Gomory (2001) said that some patients found they were offered little choice in making their own decisions and see it as patronising and coercive. Overall, 11% of patients felt forced into the treatment. Therefore these ethical restraints may deter some people from using ACT to improve their symptoms, reducing its efficacy. However it benefits people who rebel hospitalisation due to the higher control over actions there and so may benefit more.
Does it treat sz as a whole?
A weakness of ACT is that it masks the cause of SZ. ACT does not attempt to cure the cause of SZ instead combines it with antipsychotics to mask symptoms and improve rates of relapse, gaining independency. ACT does not reduce positive and negative symptoms of sz or helping with employment prospects. Therefore, this treatment is not effective due to not addressing the cause of sz.
time commitment
A strength of ACT is that there is no time limit. People can choose to stay in ACT as long as they want/need with support 24/7. Therefore this is effective as it stays with the patient long-term to help them improve their independence when living with SZ
What does ACT aim to do?
- reduce hospitalisations
- improve functioning and independence
- prevent relapse
- improve quality of life
- keep people engaged in care
