Psychological Therapies AO3

• what is the effectiveness of CBTp?

  • not for everyone
  • severe symptoms are resistant to treatment, don't believe their beliefs/behaviours are maladaptive (psychosis)
  • denial prevents successful use of CBTp, self-awareness and willingness to engage is necessary
  • positive - lack of awareness, negative - reluctance
  • effectiveness dependent on stage of SZ, varies in patients
  • only effective on those who want to change/are in a specific stage of SZ, not universal
  • NICE - CBTp more effective in reducing rehospitalisation after 18 months than neuroleptics
  • effective but only in certain contexts
• what are the social implications of CBTp?

  • not offered - long-term costly treatment (slow progress and trained therapist needed)
  • cheaper to not bother and use neuroleptics (readily available, quick, cheap from health professionals perspective)
  • although costly in short-term, actually saving money in long term - less likely to need hospitalisation in future
  • money can be available for other future treatment
  • however, availability is poor, neuroleptic use more likely, 1/10 people have access, 'postcode lottery'
  • effective and valid, but not always available and expensive, so isn't reliable
• what is the effectiveness of family therapy?

  • evidence supporting - NCCMH, meta-analysis comparing family therapy to standards drug therapy alone
  • relapse rates for FT - 26% compared to drug - 50%
  • also FT had a reduction in hospital admissions during treatment and symptom severity
  • suggests FT is valid and effective
  • however, Pharoah found results of different studies of FT effectiveness were inconsistent and there were some problems with quality of research, so overall evidence of FT is poor
  • perhaps CBTp/neuroleptics would be a more reliable treatment, more research needed to validate FT