Psychological therapies & management

• Cognitive behavioural therapy (CBT)


  • The therapist will identify the irrational thoughts, whether linked to positive or negative symptoms
  • They will then test these thoughts by discussing how likely it is that the patient's beliefs (e.g. delusions and hallucinations) are true and real, or whether there might be alternative possibilities
  • Patients would be challenged as to what evidence they have for their beliefs and what evidence there is against their beliefs
  • Patients are helped to understand how their irrational beliefs are affecting their emotions and behaviours so that they can start to realise that they don't have to let them have that effect once they know that they aren't real
• Family therapy


  • The whole family is involved in the therapy
  • The aim is to improve communication and interaction and to reduce expressed emotion (EE)
  • The therapist tries to reduce any stress within the family that might contribute to the patient's relapse
  • The therapist suggests strategies to reduce the stress to the family of caring for the relative with schizophrenia, improve the family's ability to anticipate and solve problems, reduce guilt and anger in the family members, and correct any unhelpful beliefs about and behaviour toward schizophrenia
• Token economies


  • Used in psychiatric hospitals to manage the behaviour of schizophrenic patients
  • It is based on operant conditioning and gives tokens to reinforce desirable behaviours (e.g. getting dressed)
  • The tokens are secondary reinforcers that can be swapped for a tangible reward such as sweets, a walk outside etc.