Therapies for SZ
- Created by: Natalie867
- Created on: 18-05-15 11:09
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- Therapies for SZ
- Biological therapies
- 1. Antipsychotic medication
- Conventional antipsychotics (APs)
- Dopamine antagonists-reduce stimulation of dopaminergic (nerves which use dopamine) pathways.
- Eliminate hallucinations/delusions etc
- Revolution-ised psychiatry.
- Atypical antipsychotics (e.g Clozapine).
- Fewer side-effects
- May affect serotonin as well
- May also treat negative symptoms
- Evaluation
- Traditional APs dont work on negative symtoms
- They do calm the effects SZ
- Individual differences-only affective on 30%
- Irreversible side affects, such as Tardive Dyskinesia (TD) (involuntary movement).
- Long-lasting injections? if they stop their medication then forced injections would be unethical.
- Atypicals-smaller likelihood of TD
- Dosage monitoring is vital-symptoms fluctuate so you need to get the doasge right (high dose for strong symptoms)
- Electro-convolsive therapy (ECT)
- 1. anaestetic given, 2.muscle relaxant given, 3. electrodes placed on the temple, 4. 1 minute seizure produced, 5. 3X per week for 2-4 weeks.
- Evaluation
- APA review (2001)-ECT no different than APs
- Relapse rate is high
- Benefits not long lasting
- Wipes out long-term memories
- We dont know how ECT works.
- Punishment?-used as social control.
- Effect on neuro-transmitters unknown.
- Loss of autonomy
- Not used for SZ anymore-used for severe depression
- 1. Antipsychotic medication
- Psychological therapies
- Psycho-analysis
- The therapeutic relationship (TR)-emotions about your parents get transferred onto the psycho-analysist
- Working alliance -under-standing the 'child' in the client.
- Transference-emotions unconciously shifted onto analyst
- Freud-this is unsuitable for SZ as they cannot form a TR as they are in a child state.
- Some have modified the therapy-Sulivan and Pratt (1920's)-the client is encouraged to learn adult forms of communi-cation and gain insight into the past.
- Evaluation
- Gottdiener et al (2000)
- Meta-analysis and concluded that psycho-analysis is effective.
- Drake and Sederer (1986)-leads to higher rate of hospital-isation
- Often contradictory findings
- The diagnosis has changed-earlier clients may not have been SZ
- Over stimulation causes relapse.
- Telling them how bad their SZ was made it worse.
- Expensive, time-consuming.
- Gottdiener et al (2000)
- CBT
- Our behaviour is largely a result of our thoughts
- 1. Coping Strategy Enhance-ment (CSE
- Aims to teach SZ patients to develop their own coping strategies.
- Positive self-talk, initiation/ withdrawal of social contact, relaxation, breathing exercises, drowning out voices.
- 2. Reality-testing
- Aims to test the validity of false beliefs.
- E.g. Chadwick et al (1960): participants watch, it gets paused. then they are asked: a film What happens next? they cant predict it. shows that they cant predict the future.
- Aims to test the validity of false beliefs.
- Evaluation
- Reduction in positive symptoms
- Reduction in recovery time.
- Turkington et al (2004)- has a proven role to work with APs. CBT works best with atypical APs.
- Lomas- CBT is NOT effective . Not a single trial reviewed found CBT to be effective. Affective on depression
- Older pateints are less suitable. (cant teach an old dog new tricks).
- Most patients are on APs as well-makes assessing the effectiveness of CBT difficult.
- Psycho-analysis
- Biological therapies
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