SCHIZOPHRENIA - CBTp as a psychological treatment for schizophrenia
- Created by: EmilyEther
- Created on: 13-02-19 15:10
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- CBTp as a psychological treatment for schizophrenia
- General
- treatment informed by approach
- basic assumption is that people have distorted beliefs that influence thoughts and behav
- delusions come from faulty interpretations of events
- CBTp helps patient to identify and correct faulty interpretations
- aims to reduce stress and increase functioning
- patients encouraged to trace back to origin of symptoms and get a better idea of how they developed
- patient encouraged to developed their own alternatives to bad thoughts
- How does it work?
- follows main flow of CBT
- patient identifies their ABC (Ellis) to therapist
- NORMALISATION - making the patient aware that what they are feeling is normal for their condition then reduces anxiety and sense of isolation
- CRITICAL COLLABORATIVE ANALYSIS - gentle questioning by the therapist helps the patient understand illogical conclusions
- DEVELOPING ALT EXPLANATIONS - patient develops their own alt explanations for previous assumptions. If patient can't give an alt exp, they can be helped by the therapist
- Evaluation (A03)
- NICE review of treatment found CBT was effective compared to antipsychotic medication alone
- however, patients used were using combination of CBT and medication, so effectiveness of CBT alone is diff to assess
- CBT is more effective when used at different stages of the disorder (Addington)
- lack of availability - in UK, only 1 in 10 that could benefit from treatment receive it. This figure is lower in other parts of the country
- FREEMAN - of the people who are offered CBTp, many refuse of fail to show up
- HADDOCK survey: in the NW of Eng, only 13 (6.9%) of 187 patients with sch received CBTp.
- metas don't take into account study quality. Some studies don't randomly allocate PPs.
- JUNI - clear evidence that problems with methodologically weak trials have biased findings about effectiveness of CBTp
- benefits may be overstated - JAUHAR - only 'small' effect on key symptoms of sch (delusions and hallucinations)
- in Eng and Wales, NICE emphasise non-drug therapies such as CBTp, but Soctland, SIGN emphasise antipsychotic meds
- NICE review of treatment found CBT was effective compared to antipsychotic medication alone
- Research
- ADDINGTON - found reflection was not effective is acute stages of sch
- General
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