Cognitive behavioural therapy

• What is CBT in relation to schizophrenia?

  • Cognitive behavioural therapy for psychosis, a common psychological treatment which takes place over a period of 5-20 sessions either in groups or on an individual basis
  • Aims to deal with both thoughts and behaviours
• How does cognitive behaviour therapy help?

  1. Coping strategy enhancement: individuals can identify triggers for their episodes and develop their own strategies for their psychotic symptoms and accompanying stress
  2. Can be taught cognitive strategies such as distraction, concentrating on a specific task, speaking about ones' self positively
  3. Can also be taught behavioural strategies: relaxation through breathing techniques, social withdrawal OR increased social contact, drowning out voices with loud music, etc.
• What is one strength of CBT?

  • Research support for effectiveness: Jauhar et al. (2014) reviewed 34 studies using CBT for schizophrenia and concluded there is significant effects for both positive and negative symptoms
  • Pontillo et al. (2016) found reductions in the frequency and severity of auditory hallucinations after having used CBT
  • Means that both research and clinical experience, such as NICE recommending it as a treatment, supports the benefits of CBT for schizophrenia
• What is one limitation of CBT?

  • Lack of availability: it is estimated that only 1 in 10 people in the UK who are in dire need of CBT are actually offered it
  • Freeman et al. (2013) found that a significant number of people who are actually offered CBT either fail or refuse to attend to sessions
  • This limits the effectiveness of the therapy due to the lack of accessibility as well as the unwillingness of clients to co-operate
• What is another limitation of CBT?

  • Overstated benefits: Jauhar et al. (2014)'s meta-analysis, although finding significant impact, found CBT had 'small' therapeutic effects on key symptoms and even disappeared when symptoms were blind assessed
  • Other more methodologically strong meta-analyses suggest it is less effective than originally thought, furthered by uncertainty over which is better as we receive conflicting recommendations
  • UK's NICE recommends both but Scotland's SIGN recommends drug therapy