A01: Psychological Therapy for SZ

• Psychological Therapy for SZ


  • Cognitive Behaviour Therapy (CBT)
  • Family Therapy
  • Token Economies (IN MANAGEMENT TOPIC)
• Psychological Therapy for SZ: CBT

  • What is CBT?
  • Case Example
  • Coping Strategy Enhancement (P1,2,3)
• Psy Therapy - What CBT?

  Works by helping patients identify irrational thoughts (e.g delusions) & try change them.

  Done via encouraging patient to consider extent beliefs are true & thinking about alternative explanations for what happening to them

  • Usually takes place for between 5-20 sessions, in group or individual setting.

  Clients helped make sense of how their irrational thoughts impact their feelings & behaviour - understand symptoms

  • E.G client may hear voices & believe they demons so they afraid - Normalisation involves explaining to client hearing voices is an ordinary experience.
• Psychological Therapy for SZ: CBT: Case Example


  Turkington et al (2004) treated a paranoid client who believed the Mafia were plotting to kill him

  • The therapist acknowledged the clients anxiety, and explained that there were other, less frightening possibilities and gently challenged the client's evidence for his belief in the Mafia explanation.
• Psy Therapy: CBT - Coping Strategy Enhancement: PART 1

  Tarrier (1990) divised this particular form of CBT to help patients cope with their symptoms.

  • This a 2-fold approach where therapists 1st establish rapport with patient & help them to identify potential triggers for their psychotic symptoms discussing current strategies for coping
  • 2ndly, target specific symptoms & find ways of dealing with them. Result is patients learn to recognise triggers for schizophrenic episodes & apply techniques to reduce impact of that trigger & avoid an episode.
  • 2 TYPES OF COPING STRATEGIES USED
• Psy Therapy: CBT - Coping Strategy Enhancement: PART 2

  There are 2 types of coping strategies used:

  • Cognitive strategies (involves steps like distraction, concentrating on a specific task of positive self talk)
  • Behavioural Strategies include relaxation techniques (e.g breathing exercises, social withdrawal or increasing social contact, loud music to drown out voices and behavioural experiments)
• Psy Therapy: CBT - Coping Strategy Enhancement: PART 3

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  A) ?

  
• Psychological Therapy for SZ: Family Therapy:

  • What is Family Therapy
  • Pharoah (2010)
  • Improve family ability to help
  • A model of practice
• Psy Therapy: FT: What is FT?

  This aimed at reducing characteristics that lead to dysfunctional family by improving communication & interactions that occur within the family.

  But for SZ:

  DF more associated with relapse vs cause of Sz.

  So most of focus on reducing amount of EE, as this highly linked to relapse.

  • Aims to reduce levels of expressed emotion (EE) especially negative emotions like anger & guilt which create stress
  • Reducing stress is important to reduce the likelihood of relapse

  Pharoah (2010) there a number of important strategies.
• Psy Therapy: FT: Pharoah (2010) - strategies?

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  A) ?

  
• Psy Therapy for SZ: FT: Improve family ability to help

  The therapist encourages family members to form a therapeutic alliance whereby they all agree on the aims of therapy.

  • Therapist also tries to improve families' beliefs about & behaviour towards SZ.
  • Further aim is to ensure family members achieve a balance between caring for individual with SZ & maintaining their own lives.
• Psychological Therapy for SZ: Family Therapy:

  Burbach's (2018) model:

  • Phases 1 & 2 - share information and identify resources family can offer.
  • Phases 3 & 4 - Learn mutual understanding and look at unhelpful patterns of interaction.
  • Phases 5,6 & 7 - skills training (e.g. stress management techniques) relapse prevention & maintenance.