A03- Psychological Therapies

• Evidence for effectiveness


  Jauhar reviewed results of 34 studies of CBT for schiz and conlcuded that it has a significant effect on both positive and negative effects. Pharoah et al concluded that there is moderate evidence to show that family therapy decreases hospital re-admissiona nd improves the quality of life.
• Counter to evidence for effectiveness

  Results of different studies are inconsistent. A review of evidence for token economies found only 3 studies where people with schiz have been randomly allocated to conditions, with a total of 110 patients. Only 1/3 of studies showed improvement in symptoms and none yielded useful information about behaviour change.
• Treatments improve quality of life


  CBT allows a patient to make sense of and challenge their symptoms. Family therapies help to reduce stress of living with schiz in a family. Token economies help make individuals' behaviour more socially acceptable so that they can re-integrate into society.
• Treatments improve quality of life but not cure


  They do not sure schiz. Whereas, biological treatments reduced the severity of symptoms and this failure to treat schiz is a weakness of psychologcial treatments.
• Ethical issues


  Privileges and services become more available to patients with mild symptoms and less so with those with severe symptoms of schiz that prevent them from complying with desirable behaviours. Thus, most ill patients suffer from discrimination and in turn reduces use of token economies in psychiatrics.
• Ethical issues via conditioning

  CBT may challenge a person's paranoia but there is no point given where a therapist has to stop and therfore may interfere with an individual's freedom of thought through conditioning.
• Quality of the evidence of effectiveness

  Many small-scale studies in which mental health professionals have compared patients before and after psychological treatments have found more positive results. But there is often a lack of a control group and not randomly allocated. Thus coclusions are more generally optimistic in reviews.
• Alternative psychological treatments


  Other psychologcial therapies can be more helpful that are less known. The National Institute for Health and Clinical Excellence (NICE) recommends art therapy, with a qualified art expert, working with people that have schiz.