Psychological treatments

• List the 3 Psychological Therapies for SZ

  -CBTp

  -Family Therapy

  -Token Economies
• Outline CBT

  The cognitive aspect of CBT refers to the ways in which the therapy enables the client to challenge negative/dysfunctional thoughts

  
  

  the behavioural aspect of CBT helps the client to modify their actions and responses and to their dysfunctional thoughts

  
  

  It usually lasts around 12 weeks and involves the therapist aiming to help the client understand what is real/what is fantasy, and putting routines and strategies in place to live life productively

  
  

  CBT may also help clients with schizophrenia in terms of developing a range of social skills and problem-solving skills which should equip them with the tools and mechanisms to manage their condition and to avoid relapse
• Explain the 5 Steps of CBTp

  -assessment; patient expresses thoughts about their experience & realistic goals are set

  
  

  -engagement; therapist empathises with patient

  
  

  -ABC Model; patient gives their activating events (A), that appear to cause their behavioural (B), consequence (C)

  
  

  -normalisation; information about other sufferers is given to help patients feel less isolated and stigmatised

  
  

  -crucial collaborative analysis; therapists use gentle questioning to help patients understand maladaptively

  
  

  -developing alternative assumptions
• CBT strengths


  Research support

  
  

  NICE review found that, when compared with drug treatment alone, CBTp was more effective in reducing rehospitalisation rates up to 18 months after treatment.

  
  

  McGorry et al. found after 6 months of treatment, 36% of patients with high risk of developing SZ who had received psychotherapy developed SZ compared with 10% who received CBTp and drugs
• CBT weaknesses


  Not everybody is suited to CBT and as schizophrenia exists on a spectrum it may only be appropriate for those whose symptoms are mild or easily managed
• Outline Family Therapy


  Family therapy sessions aim to reduce the stress of schizophrenia for all those involved: the patient themselves and their immediate family who have to cope with the illness indirectly on a daily basis

  
  

  Family therapy sessions will aim to reduce stress, help family members process their thoughts and feelings about the illness and come together to find practical, feasible problem-solving solutions to the situation
• Strengths of Family Therapy

  Pharoah et al. reviewed 53 studies of family therapy, finding an increased compliance with medication, improved general functioning, and reduction in relapse and readmission during treatment and after 24 months

  
  

  Family therapy should result in a schizophrenia patient feeling less alone and isolated which should ultimately benefit the economy as it means less reliance on external mental health providers plus the patient may be able to work which means fewer days absence lost to sickness
• Family therapy weaknesses


  Family therapy may actually worsen someone's symptoms if they feel that they are being forced to interact with or depend on people who are emotionally destructive i.e. the family dynamic is too toxic but the patient may not be able to express or admit this to a health professional

  
  

  Doesn't cure schizophrenia on lessens the effects