Psychological therapy

• CBT

  Assumption faulty cognition needs to be changed
• CBT

  Main technique is based of Ellis ABC model
• CBT

  People with schiz encouraged to take a reality test to their hallucinations and delusions
• CBT

  Pushed to challenge their beliefs and question where voices originate from
• CBT

  Patients role-play exercises and homework to test out their faulty thinking and are helped to see the consequences differently
• Chadwick et al (study of CBT)

  • Man with schiz believed he had ability to predict what people are going to say
  • Asked to prove powers and was shown 50 video tape scenarios
  • Nigel didn't get one prediction right
  • Reality tested to prove nigel doens't have special power
  • Not generalisable to general population (1 man)
• Advantages of CBT

  • Sensky et al found CBT effective for patients who hadn't responded to treatment
  • Patients continued to improve even after 9 months
  • CBT puts patients in charge of their own treatment by teaching self-help strategies
• Weaknesses of CBT

  • Only treats schiz symptoms
  • Difficult to measure effectiveness
  • Patient needs a degree of self-awareness for it to work
  • CBT time-intensive and drop out is high
  • Style of CBT doesn't work for all
• Family therapy is another treatment
• Family therapy

  Developed over past 40 years and is based on idea family dysfunction can increase the risk of schiz
• Family therapy

  Reduce conflict in family and high emotion amongst members
• Family therapy

  Happen by helping family form alliances, reduce the burden of care and limit outbursts of anger
• Advantages of Family therapy

  • Has had some success
  • Useful for patients who lack insight to their own thoughts
• Weaknesses of Family therapy

  • Informed consent from all members is difficult
  • Issues with confidentiality
  • Families need to be engaged and open about changing behaviour