psychological therapies

• what are the 3 psychological therapies?

  1. cognitive behavioural therapy
  2. family therapy
  3. token economies
• define CBT

  talking therapy to challenge and modify irrational thoughts
• key features of CBTp

  • identify irrational beliefs and challenge them
  • encourage alternative explanations for delusions and hallucinations
  • use coping strategies
• effectiveness of CBTp

  • Jauhar et al - significant effect in reducing positive symptoms
  • Tarrier et al - greater symptom reduction when combined with drug therapy
• strength of CBTp - evidence

  • Jauhar et al conducted a meta-analysis finding a significant effect on positive symptoms
  • helps patients reinterpret symptoms and improve functioning
  • CBTp is effective
• weakness of CBTp - holistic

  • most effective when used alongside antipsychotic medication
  • Tarrier et al - patients receiving both showed greater symptom improvement
  • supports an interactionist approach suggesting CBTp isn't a sole treatment plan
• weakness of CBTp - limited

  • CBTp isn't suitable for patients with severe cognitive impairments
  • 1 in 10 patients can access CBTp due to lack of trained therapists
  • limited accessibility and suitability
• define family therapy

  aims to reduce family-related stress and communication issues that contribute to relapse
• key features of family therapy

  • improves family communication and reduces expressed emotion
  • helps relatives understand disorder and how to support the patient
  • focuses on problem-solving and reducing stress
• effectiveness of family therapy

  • Pharoah et al - led to lower relapse rates and improve medication compliance
• weakness of family therapy - distressing

  • ethical issues as can lead to feelings of guilt or blame
  • discussing issues of expressed emotion and family dysfunction
  • cause reluctance to engage in therapy
• strength of family therapy - evidence

  • Pharoah et al conducted meta-analysis and found family therapy was associated with lower relapse rates
  • creates a less stressful home environment which reduces risk of relapse
  • effective
• strength of family therapy - economy

  • cost-effective treatment
  • decreases hospital readmissions which lowers overall treatment costs
  • reduces the burden on psychiatric services
• define token economies

  used in institutional settings to reinforce desirable behaviours
• what process does token economies follow?

  operant conditioning
• how do token economies work?

  • tokens are given as a reward for appropriate behaviour
  • tokens can be exchanged for rewards
• what does token economies help patients develop?

  • independent living skills
  • improvement in motivation
• effectiveness of token economies

  • Ayllon & Azrin - effective in increasing desirable behaviours

  
  

  • don't reduce core symptoms and only improve management
• strength of token economies - evidence

  • Ayllon & Azrin - in a hospital, token economies led to increase in desirable behaviours
  • help develop independent living skills
  • improves management of symptoms
• weakness of token economies - ethics

  • unethical as discriminate against complex patients
  • severe schizophrenia struggle to comply and receive fewer rewards leading to inequality
  • ethical concerns
• weakness of token economies - effectiveness

  • only effective within institutional settings
  • once token economies are removed then learned behaviours don't persist outside
  • short-term management rather than long-term treatment