Psychological therapies for schizophrenia

• CBT for Schizophrenia:

  • Takes place between 5 and 20 sessions in groups or an individual basis
  • Identifies irrational thoughts + tries to change them
  • Can help people better cope with symptoms and not get rid of them
• How CBT helps:

  • Make sense of how their delusions + Hallucinations impact their feelings and behaviour
  • Understanding where symptoms come from - Hugely helpful
  • Delusions can be challenged - Come to learn their beliefs are not based on reality
• Family therapy:

  • Improve communication and interaction between family members
  • Some therapies see the family as the root cause of the condition
  • Concerned with reducing stress within the family - Might contribute to a person's risk of relapse
  • Aims to reduced expressed emotion (EE)
• How family therapy helps:

  Pharoah: Strategies used to improve functioning of family

  • Form a therapeutic alliance with all family members
  • Improving the ability of the family to anticipate and solve problems
  • Improving families beliefs about and behaviour towards S

  Work by reducing stress and EE levels and increase chances of people complying with medication - Reduce chances of relapse and re-admission to hospital
• Token economies:

  • Reward systems used to manage the behaviour of people with S - Those who have developed patterns of maladaptive behaviour through long periods in psychiatric hospitals
  • People develop bad hygiene / remain in pyjamas all day
  • Modifying bad habits - Does not cure schizophrenia but improves the person's quality of life and help them live outside hospital
• Token economies - Tokens:

  • Given when they have carried out a desirable behaviour that has been targeted for reinforcement
  • Immediacy of reward important - Stops delay discounting reduced effect of a delayed reward
• Token economies - Rewards:

  • Tokens being swapped for tangible rewards
  • Operant conditioning - Tokens are secondary reinforcers because they only have values once it is learnt they can obtain rewards
• Evaluation of psychological treatments - Treatments improve quality of life but don't cure:

  • All treatments aim to make schizophrenia more manageable and improve quality of life
  • All the pros of CBT, Family therapy and Token economies

  Limitation: Failure to cure schizophrenia and may not always work
• Evaluation of psychological treatments - Ethical issues:

  • TE - Privileges become more available to patients with mild symptoms and less for those with more severe
  • Most severely ill patients suffer discrimination + Some families have challenged the legality of this - reducing the usage of TE
  • CBT - Challenges someone's paranoia - May interfere with freedom of thought
• Evaluation of psychological treatments - Quality of the evidence for effectiveness

  • Small scale studies where patient compared before and after treatment - Found more positive results than the ones described

  HOWEVER - Lack a control group + No random allocations

  Studies

  • Studies that are included in reviews conclusions are more optimistic
  • Reviews with tight controls on what studies are included may be too pessimistic in conclusions

  Limitation: Disparity of conclusion may question effectiveness