CBT + AO3

• Aims

  • challenge and change irrational thoughts and distorted perceptions
  • modify hallucinations and delusional beliefs
• Logistics

  • anti-psychotics are usually given first to make the patient more accessible to therapy - this will help them more
  • every 10 days
  • around 12 sessions - can be one to one or in a small group
  • mostly addresses the positive symptoms
• Involves

  • obtaining a detailed evaluation of the client's ...:
  • irrational thoughts
  • beliefs and experiences
  • activating events/triggers - makes them feel anxious
  • any current strategies
• CHALLENGES irrational beliefs/experiences, helping the clients develop further techniques

  • Hallucinations
  • challenges the auditory hallucinations, explains the voices are not real
  • they are not recognising their thoughts/inner voice as their own due to meta-representation
  • Delusions
  • challenges delusional thinking using reality testing (points our evidence which counters the delusional thoughts)
  • suggests alternative interpretations and perceptions of stimuli - helps the client consider other more accurate assessments of the situation
• Cognitive Coping Strategies

  • distractions to reduce intrusive thoughts
  • positive self talk and mantras
  • recognising emotional instability is part of SZ and using muscle techniques to help manage build up of stress
  • being taught to recognise small signs of relapse to access support
• Homework

  • putting techniques into practice outside the CBT sessions
  • practicing coping strategies
  • practice use of positive self talk
  • keep a diary recording activating events and how they handled it
• Strengths

  • Tarrier
  • studied patients who had 20 sessions of personal therapy CBT with drug therapy
  • found this was more effective than drugs or suportive counselling alone
  • 1/3 achieved a 50% reduction in psychotic experiences compared to 15% in counselling
  • 15% in CBT were free from all positive symptoms, but only 7% in the counselling group and 0% in the drug group
  • suggests CBT is very effective in reducing the positive symptoms of SZ, especially in contrast to drugs
  • = CBT should be widely available and offered to SZ sufferers
  • CBT is more ethical
  • involves the development of skills and strategies to help the client, they are able to contribute to their treatment
  • no problematic side effects as associated with drug treatment
  • BUT CBT can only target positive symptoms and is difficult to use with very psychotic patients
• Limitations

  • CBT is supposed to be a supplement therapy, more effective when used together
  • suggests treatments for SZ should not be solely psychological or biological but best results occur when therapies are combined
  • Sudak found increased compliance when anti-psychotic drugs were combined with CBT
  • an interactionist approach may be more appropriate and effective in treating SZ