Psychological Treatments

• Is Cognitive Behavioral Therapy (CBT) more or less expensive than medication?

  More expensive
• Why might people be less likely to continue their treatment with CBT?

  Because it is a more expensive treatment than medication
• What is a significant issue regarding the effectiveness of CBT?

  The true effectiveness of CBT alone is often questioned
• Why is it difficult to determine the effectiveness of CBT alone?

  Because patients often receive medication while undergoing CBT
• What has research shown about the combination of CBT and medication?

  The greatest improvements in treatment are seen when patients receive CBT in addition to drugs
• What are the aims of Family Intervention Therapy?

  • Improve quality of communication and interaction within a family
  • Improve positive and reduce negative forms of communication
  • Increase tolerance levels and decrease criticism among family members
  • Decrease feelings of guilt and responsibility for the illness in family members
  • Educate the family about the disorder and what to expect
• What should the Family Intervention Therapy program include?

  An education program, analysis of family relationships, family sessions, and a relatives support group
• How long should the Family Intervention Program continue?

  At least nine months
• What is thought to be a reason for the success of Family Intervention Therapy?

  It reduces stress and improves medication compliance
• What did William McFarlane conclude about family therapy for schizophrenia?

  It was one of the most consistently effective treatments
• What did NICE recommend regarding family therapy for schizophrenia patients?

  Family therapy should be recommended for everyone with a diagnosis of schizophrenia
• What were the relapse rates after 9 months for the standard group versus the Family Therapy group?

  50% for the standard group and 8% for the Family Therapy group
• What does the long-term effectiveness of Family Therapy suggest?

  It may prolong relapse rather than prevent it entirely
• What are the strengths and weaknesses of Family Intervention Therapy?

  Strengths:

  • No side effects or medical risks
  • Cost offset by reduced hospitalization costs

  
  

  Weaknesses:

  • Subjective measurement of expressed emotion (EE)
  • Difficulty in evaluating individual components
  • Effectiveness questioned due to concurrent medication
  • Families needing therapy may be least receptive
  • Family therapy is expensive
• What is the rationale behind Token Economies for treating schizophrenia?

  If the cause of schizophrenia is maladaptive learning, then unlearning faulty behavior should be effective
• What is the role of positive reinforcement in Token Economies?

  To increase adaptive target behaviors
• What is the purpose of extinction procedures in Token Economies?

  To ignore certain maladaptive behaviors to reduce their repetition
• What did Ayllon and Azrin find in their study on Token Economies?

  The number of positive behaviors increased from 0 to over 40
• What did Paul and Lentz find regarding Token Economies over six years?

  Both positive and negative symptoms were significantly reduced
• What is a potential ethical issue with Token Economies?

  Human rights may be denied as rewards can include basic rights
• What are the strengths and weaknesses of Token Economies?

  Strengths:

  • Creates a pleasant hospital experience
  • Supported by research evidence

  
  

  Weaknesses:

  • Ethical concerns regarding rewards
  • Difficult to implement consistently
  • May only have short-term benefits
• What is the basic assumption of Cognitive Behavioral Therapy (CBT)?

  Maladaptive thinking leads to maladaptive behavior
• What is the aim of CBT?

  To change dysfunctional thoughts into more realistic alternatives
• What is the first step in the CBT process?

  Develop a rapport with the patient
• What is the purpose of homework assignments in CBT?

  To reflect on and consolidate the use of strategies between sessions
• What are the strengths of Cognitive Behavioral Therapy (CBT)?

  • Supported by research evidence
  • Effective for both positive and negative symptoms
  • Long-term benefits evident after treatment
  • No side effects compared to medication