family therapy/CBT a03

• One limitation is that CBT is only able to significantly ehlp a minority fo people. CBT requires willingness and motivation to engage in the process otehrwise the treatement will not be successfu. For example those with really extreme symptoms for example paranoid schizophrenica may find if difficult to engage in therapy as they could be reluctant to trust therapists. This would mean that the therapist would be unable to challenge the patients beliefs meaning it would not be effective in reducing their symptoms.

  Furthermore data shows only 1 in 10 people are able to access CBT therefore it can't reach many people who are suffering
• • There are methodological issues with the research on the effectiveness of (family therapy/CBT) for schixophrenia.
  • In most reserach patients are also taking AP medication so it is hard to assess the effectiveness of the therapy (CBT/FAMILY) alone.
  • Furthermore there are problems with meta-analysis studies as there is varied study quality as some studies may use different sample sizes, different lengths of therapy and experience of therapist.
  • (pharoahs' large number from china FAMILY)
  • failed to randomly allocate participants which may translate into biased findings about the effectiveness of of family therapy,could choose those more suitable and willing.
  • Morevover a recent meta-analysis found using family therapy as sole treatement had a 'small' therapuetic effect on key symptoms (assessed blind) which suggests (FAMILY/CBT) alone is not an effective therapy for schixophrenia
• Research evidence suggests that family therapy can be effectvie in improving clinical outcomes. For example pharoah reviewed 53 studies published and found that it significantly reduced hospital readmission over the course of a year and improves quality of life for patients and their families. This supports the effectiveness of family therapy. However many psychologists suggest the main reason for its efefctiveness may have more do do with the fact it increases medication compliance (something pharoah found to be true) which undemrines the evidence suggesting beneficial effects are not as a reuslt of the family herpay itself, furthermore methodological isues
• an advantage of this therapy (family therapy) is its considerable economic benefits.

  • FAMILY - (The NICE review of family therapy studies demonstrated that it was associated with significant cost savings hwne offered to patients alongside the standard care)
  • CBT - (Kuipers found CBT may cost more initially but is beneficial cost wise in the long run as schizophrenics with CBT are less likely to need emergency help in the future
  • the extra cost of cbt/family therapy is offset by a reduction in costs of hospitalisation because of lower relapse rates
  • There is also evidence that relapse rates are lower after the completion of intervention which suggests that the savings could be even higher (CBT he found 50% of those with CBT had improved)(since 1980, several family management programs have been evaluated, significant reduction in relapse when compared to standard psychiatric care from 49 to 13%.)
•  Cognitive–behavioural therapy (CBT) is considered to be effective for the symptoms of schizophrenia, however the majority of reserach support from cbt comes from meta analysis......