Psychological Therapies For Schizophrenia

• What are the steps involved in CBT for schizophrenia?

  1. Establish therapeutic alliance (trust)
  2. Psycho-education (facts about the illness)
  3. Normalising symptoms (stress management)
  4. CBT interventions (belief modification)
• What does stress management in CBT involve?


  It involves evaluating problems, triggers, consequences, and coping strategies
• What techniques are taught in stress management for schizophrenia?

  Distraction tasks, breathing, and relaxation exercises
• How effective is stress management when combined with drugs for schizophrenia patients?

  Patients show considerable improvement compared to those on drugs alone
• What is the goal of belief modification in CBT for schizophrenia?

  To counter delusional beliefs and/or hallucinations
• What process is involved in belief modification?

  Cognitive challenge, where clients regard their responses to symptoms hypothetically
• What are the concerns regarding the effectiveness of CBT for schizophrenia?

  Mixed evidence on patient insight and biological causes
• What percentage of patients show reduced positive symptoms with CBT?

  70% of patients
• What role does CBT allow patients to take in their recovery?

  It allows the patient to take an active role in recovery
• What are some limitations of CBT for schizophrenia?

  It is not a cure, requires effort, and can worsen symptoms in 30% of cases
• What did Vaughn and Leff (1978) find regarding relapse in schizophrenia?

  • Schizophrenics are more likely to relapse in homes with high levels of Expressed Emotion (EE)
  • Therapy aims to develop cooperative family relationships and reduce EE
• What strategies did Fiona Pharoah (2010) suggest for family therapists?


  Forming therapeutic alliances and reducing stress, anger, and guilt in family members
• What are the benefits of family intervention therapy for schizophrenia?

  It helps reduce hospital admissions and improves medication compliance
• What are some challenges associated with family intervention therapy?

  It is expensive and difficult to get all family members involved
• What ethical concerns exist regarding family intervention therapy?

  Difficulty accessing details and measuring effectiveness
• What are token economies in the context of schizophrenia treatment?


  • A reward system to manage behavior
  • Particularly used for maladaptive behaviors in long-term patients
• When were token economies primarily used for treating schizophrenia?

  In the 1960s and 70s
• What is the purpose of using tokens in token economies?

  To reinforce desirable behaviors in patients
• How are tokens used in the token economy system?

  Tokens are given immediately after performing a desirable behavior
• What do tokens represent in the token economy system?(operant conditioning)

  They are secondary reinforcers that can be exchanged for rewards
• What types of rewards can tokens be exchanged for?

  Sweets, cigarettes, magazines, or privileges
• What are the strengths and weaknesses of the token economy system?

  Strengths:

  • Helps integrate patients into society
  • Provides a structured reward system

  
  

  Weaknesses:

  • Only one in three studies show effectiveness
  • Ethical concerns for severely ill patients
• Why is the token economy system not widely used now?

  It is not effective for severe symptoms and raises ethical issues
• What alternative method to manage schizophrenia does Chiang (2019) suggest?


  • Art therapy as a high gain, low risk alternative
  • Small scale research shows some success