Psychological Therapies

• what is an introduction to the cognitive section of psychological therapies?

  • principle part of psychological approach's explanation for SZ is unhealthy cognitive processes that can occur in SZ sufferers
  • if this is correct, then psychological therapies should revolve around correcting that
• what is an introduction to the family section of psychological therapies?

  • principle part of psychological approach's explanation for SZ is confusing and dysfunctional communication within families of a schizophrenic
  • if this is correct, psychological therapies should revolve around correcting this
• what is CBTp?

  • therapy that aims to help the patient identify, then challenger or modify the delusions and maladaptive thinking, especially through the use of evidence, especially reality testing, to replace them with constructive thinking that will lead to healthy behaviour
• what does CBTp involve?

  • during regular sessions, patient is encouraged to trace back to origins of symptoms in order to gain insight into the way in which they may have developed
  • promotes increase in social activity and the use of relaxation techniques
  • range of psychological explanations offered, which may help to reduce the stress/anxiety that goes along SZ
  • therapist will make maladaptive thoughts conscious - psychosis
  • can't prevent hallucinations/delusions but can help cope with them
• what are some key components of CBTp?

  • delusion investigation - reality testing
  • relapse prevention strategies
  • socratic questioning
• what is delusion investigation - reality testing?

  • for those who experience delusions, these can be tested and challenged in a controlled environment so that the SZ may see them as the false beliefs they are
• what is relapse prevention strategies?

  • schizophrenic can recognise and anticipate the signs/symptoms of relapse ('triggers')
  • therapist and patient create a checklist of warning signs that might signal a relapse of the illness, and situations/triggers that might make relapse more likely
  • helps develop a plan, which can be used by the social network and family of schizophrenic
• what is socratic questioning?

  • curiosity-driven questioning asked by therapist during therapy sessions to help schizophrenic identify the errors in their thinking, including challenging the patient to find evidence that supports their delusions
  • lack of evidence should start to undermine the patients belief in their delusions
• what is family therapy?

  • therapist works with family and patient to develop strategies to cope better with SZ and its symptoms
  • this will hopefully lead to more supportive/warmer atmosphere (reduced relapse-instigated EE) helping patient make better progress and make relatives feel more positive about their supporting role
• what does family therapy involve?

  • takes place in peoples home
  • family taught about psychosis, SZ as a diagnosis and how EE can trigger relapse
• what does the therapist encourage families to do?

  • ask questions for proper understanding
  • patient to discuss symptoms as they are experts of them
  • learn more constructive ways of communicating (avoiding EE)
  • concentrate on good rather than negative events
  • need to find a way to cope with feelings of anger without resorting to EE behaviour
  • learn to recognise early signs of relapse so can respond rapidly to reduce severity of it
• what did Pharoah 2010 do?

  • meta-analysis of studies to investigate the effectiveness of family intervention
  • outcomes compared to 'standard care' alone
  • identified a range of strategies by which family therapists aim to improve functioning with a member suffering from SZ
  • e.g. forming therapeutic alliance with all family members and reduction of anger and guilt in family members
  • suggested these work by reducing levels of stress/EE, whilst increasing patients complying to medication
  • reduce likelihood of relapse and re-admission to hospital