Psychological therapies

• Psychological therapies


  Cognitive behaviour therapy (CBT)

  The aim of CBT involves helping people identify irrational thoughts and trying to change them. This will not get rid of symptoms of SZ but it can make people better able to cope w/ them. CBT can help people make a better sense of how their hallucinations and delusions impact their feelings and behaviours, which can help to reduce anxiety.
• Psychological therapies


  Family therapy

  Takes place w/ families rather than individual clients, aiming to improve the quality of communication and interaction between family members. Pharoah et al. (2010) identified a range of strategies by which family therapists aim to improve the functioning of a family w/ a member experiencing SZ:

  • Forming a therapeutic alliance with all family members
  • Reducing the stress of caring for a relative with schizophrenia
• Psychological therapies


  Family therapy 2

  • Improving the ability of the family to anticipate and solve problems
  • Reduction of anger and guilt in family members
  • Helping family members achieve a balance between caring for the individual with schizophrenia and maintaining their own lives
  • Improving families’ beliefs about and behaviour towards schizophrenia
• Psychological therapies


  Token economies

  Are reward systems used to manage the behaviour of people with schizophrenia, in particular those who have developed patterns of maladaptive behaviour through spending long periods in psychiatric hospitals. Modifying these bad habits does not cure SZ but it improves the person's quality of life and makes it more likely that they can live outside a hospital setting.
• Psychological therapies


  Token economies 2

  Tokens are given to patients when they have carried out a desirable behaviour that has been targeted for reinforcement. The tokens can be swapped later for more tangible rewards in the form of materials (sweets/magazines) or services (having a room cleaned).
• Psychological therapies -evaluation


  Ethical issues. In particular token economy systems have proved controversial. Major issue is that privileges and services become more available to patients w/ mild symptoms and less so for those w/ more severe symptoms of SZ that prevent them complying w/ desirable behaviours. This means that the most severely ill patients suffer discrimination in addition to other symptoms, which in turn reduced the use of token economies in the psychiatric system.
• Psychological therapies -evaluation 2


  Improve quality of life but do not cure SZ. CBT helps by allowing a person to make sense of their symptoms. Family therapy helps by reducing the stress of living w/ SZ in a family. Token economies help by making the individual's behaviour more socially acceptable so that they can better re-integrate into society. These things are all worth doing, but should not be confused w/ curing SZ.
• Psychological therapies -evaluation 3


  There is only modest support for the effectiveness of psychological treatments for SZ. For example, Jauhar et al. (2014) reviewed the results of 34 studies of CBT for SZ. They concluded that CBT has a significant but fairly small effect on both positive and negative symptoms.