Schizophrenia

• Cognitive Behavioral Therapy (CBT) is the main psychological treatment for SZ, aimed to help patients identify and challenge the irrational beliefs of the patient which influences their behaviour in maladaptive ways.
• The therapist challenges the irrational beliefs of the patient and helps them develop alternative belief systems
• Therapists often use the ABC model by Ellis to understand and change faulty cognitions
• In the ABC model, faulty cognitions start with an activating event (A), lead to a belief (B), and result in certain behaviors (C - consequences)
• The therapist helps the patient dispute irrational beliefs using logical or empirical evidence, leading to restructuring of beliefs into rational ones
• Reality testing is a process where patients demonstrate to themselves that their irrational thoughts (hallucinations and delusions) are not real
• Sensky (2000) showed that CBT can reduce positive and negative symptoms in patients who resisted drug treatments
• CBT success supports the theory that cognitive factors are involved in disorders
• Patients may end CBT treatment early due to its length (up to a year) and worsening symptoms before improvement
• CBT requires patient engagement, which may be challenging for severely schizophrenic individuals with negative or positive symptoms
• Family therapy aims to improve the home situation of schizophrenic patients to reduce the risk of relapse
• Family therapy educates families on schizophrenia symptoms and aims to reduce conflict, stress, self-sacrifice, improve communication, and problem-solving skills within the family
• Leff (1985) found that family therapy reduced relapse rates in schizophrenic patients compared to standard outpatient care
• Family therapy may not maintain positive behavior patterns in the long term
• Some families may not be willing to engage in family therapy, affecting its effectiveness
• Token economies are based on Skinner's operant conditioning and use tokens as positive reinforcement for desired behaviors in schizophrenia management
• Tokens are exchanged for rewards like activities or chocolate, encouraging behavior shaping towards ideal behaviors
• Token economies aim to produce easier to manage behavior in mental hospitals or prepare long-stay patients for community transfer
• Dickinson found that token economies can be effective in improving behaviour in psychiatric therapies
• Token economies do not directly treat symptoms of schizophrenia but manage negative symptoms like poor attention and motivation
• Token economies do not directly treat symptoms of schizophrenia but manage negative symptoms like poor attention and motivation
• Some patients may find token economies infantilizing or degrading, affecting their willingness to engage in the therapy
• Token economies may not be effective with severely unresponsive patients and could potentially worsen schizophrenia symptoms
• Dickinson found that token economies can be effective in improving behavior in psychiatric therapies