CBT

• CBT is used to identify maladaptive, intrusive and delusional thought.

  This is because the cognitive explanation states schizophrenia is the result of dysfunctional thought processes in the form of meta representation and central control.
• It uses disputing techniques:

  • logical - doesn’t make sense to think that
  • empirical - no evidence behind the thoughts
  • pragmatic - it’s not useful to think that
• NICE recommends patients attend 16 sessions.

  They also outline normalisation as a tactic which reinforces patients that lots of people experience hallucinations and delusions which helps them feel less alienated and reduces the stigma behind them and this helps reduce feelings of anxiety.

  It also outlines reality testing which uses gentle questioning to dispute and tries to get patients to see if their symptoms are reality. They may also set homework tasks to aid in this.
• AO3

  :)

  Reserach to support CBT comes from NICE who found that CBTp was effective in reducing rehospitalisation rates for up to 18 months vs antipsychotics.

  They also reduce symptom severity as there’s evidence to suggest they improve social functioning.

  Jauhar et al reviewed 34 studies of CBT and found improvement in both positive and negative symptoms which is useful when only some treatments help positive symptoms.
• AO3

  :(

  Jauhar et al found that small improvements in symptoms disappeared when they were assessed blind which is where the assessors didn’t know whether the patients were taking therapy or were in a control group.

  A meta analysis also found similar design problems as different place recommended different treatments e.g. england and wales recommended CBTp and scotland recommended antipsychotics.

  Therefore there are inconsistencies in the effectiveness and appropriateness of treatment which leads to the questioning of the therapy.
• AO3

  :(

  Other issues of CBT is that you can’t determine causality.

  Thos is because CBTp is often used alongside antipsychotics.

  Because of this you can’t assess the effectiveness of the therapy separately and therefore you can’t determine whether CBT helps to relieve symptoms or antipsychotics are the ones relieving symptoms.