Psych therapies : CBT

• The National Institute for Health and Care Excellent (NICE) recommend CBT in the treatment of schizophrenia (CBTp–psychosis)
• What’s CBTp aim?

  help patients to identify

  irrational thoughts and change them
• What does CBTp involve?

  May have argument/discussions about how likely these are to be true and coming up with other possible alternatives – coping

  strategies.
• What are patients helped to make sense of?

  make sense of how

  delusions and hallucinations impact on behaviour and feelings– gaining an understanding of this can help reduce anxiety in patients
• What do the sessions consist of?

  Usually between 5-20 sessions

  Groups and/or individual
• What will CBT not get rid of?

  CBT will not get rid of

  the symptoms of schizophrenia but it can make patients better able to cope with them i.e. coping strategy enhancement.
• ABC (DE) model Ellis 

  This is used to understand the source of the faulty cognition,and provide a process to cognitively restructure irrational beliefs (delusions)
• What’s an explanation for the ABC(DE) model used for people with SZ?

  -Activating event - drug treatment causes side effects

  -beliefs - hospital staff are trying to kill them 

  -consequences - refusing treatment 

  -disputing irrational beliefs (logical) - the staff have no reason to kill them 

  -restructured belief (effect) - the drugs are necessary
• What is the cognitive strategies ?

  E.g. distraction, concentrate on a specific task; positive self talk
• What are the behavioural strategies ?

  E.g. such as relaxation techniques (e.g. breathing exercises),

  social withdrawal/ increasing social contact; loud music to

  drown out voices, behavioural experiments
• One strength is there's evidence for effectiveness of using CBT to treat SZ.for example, Tarrier reviewed 20 controlled trials of CBT using 739 patients showing consistent evidence that CBT reduces persistant positive symptoms in chronic patients and may have modest effects in speeding recovery in acutely ill patients.Therefore this matters as it suggests CBT is viable treatment for SZ, particularly for reducing positive symptoms such as delusions and hallucinations.
• One limitation of CBT is it may not be an appropriate therapy for all sufferers of SZ.As CBT relies on the individual to engage with the therapy and therapist,it may be especially difficult for those who experience paranoia.In addition those who are too disorientated/ agitated to form trusting alliances with practitioners.therefore this matters as it's important to consider the individual sufferer when suggesting CBT as a treatment option as it may only be appropriate when the sufferer is in a position to engage in the process of CBT
• Another limitation of CBT for treatment with people who have SZ it’s a very expensive treated.As there’s multiple sessions needed to treat the patient due to it being a long process and it’s mostly only one therapist that treats the patient.That means the NHS will have to pay for a lot of therapists.Whereas antipsychotics are cheaper to make and for the NHS to supply.Therefore,this matters because antipsychotics may be better for some patients with sz as it’s cheaper and doesn’t take as long as CBT.