psychological therapies for schizophrenia

• psychological explanations & the therapies used


  -cognitive explanations: CBT

  -family dysfunction: family therapy
• CBT


  -linked to thoughts; emotions & behaviours

  -5-20 sessions

  -group/individual sessions

  
  

  -stages of CBT for SCZ:

  -1: assessment - therapist & client meet (ask about thoughts & feelings)

  -2: engagement: pick something signifiant & ask client about it

  -3: ABC model (Ellis) tackles irrational beliefs

  -4: normalisation: make client see what they're seeing as an extension of reality - reduces fear/anxiety/isolation of client

  -5: collaboratory reality testing - therapist disputes the client's beleifs

  -6: developing alternative explanations: get client to alter their coping strategies & shows delusions are not reality
• family therapy


  -done with families & the SCZ patient

  -aims to improve the quality of communication patterns; tolerance and understanding whilst decreasing feelings of guilt and anger

  -families learn how to help the SCZ person when they are in psychosis and form therapeutic alliances with all family members

  
  

  -Pharoah et al: these strategies work by decreases stress & expressed emotion whilst increasing the chances of patient complying with medication

  
  

  -Burbach: model for working with SCZ families:

  -phase one: share basic info, emotional & practical support

  -phase two: identify resources & what family can offer

  -phase three: express feelings & encourage mutual understanding

  -phase four: identify unhelpful patterns of understanding

  -phase five: skills training e.g., stress management

  -phase six: relapse prevention planning

  -phase seven: maintenance for the future

  
  

  -helpful for positive symptoms
• psychological therapies for SCZ - AO3


  Strength(s):

  -research support for CBT. Meta-analysis found 44.5% reached a 20% reduction in overall symptoms; 52.9% reached a 20% reduction in positive symptoms. Sample of over 1k (D: large sample, generalisation). D: adding CBT to drug treatments brings minimal improvements.

  -research support for effectiveness of family therapy. McFanane: family therapy = one of the most consistently effective SCZ treatments. Decreases relapse rates by 50-60%. Is useful.

  
  

  Weakness(es):

  -CBT helps deal with symptoms but does not treat/cure SCZ. Not fully useful.

  -CBT is not good for negative symptoms of SCZ as it requires motivation and avolition is a negative symptom. Other treatments = more useful/effective.

  -quality of evidence for CBT: studies into CBT = wide range of symptoms & techniques. Hard to conclude that the effects are reliable. May have different symptoms and respond differently to the types of CBT.