Psychological therapies for schizophrenia

Psychological therapies for schizophrenai for AQA A.

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Psychological therapies for schizophrenia
Cognitive behavioural therapy
The basic assumption of CBT is that people often have distorted beliefs, which influence their
behaviour in maladaptive ways. For example, someone with schizophrenia may believe that their
behaviour is being controlled by someone or something else. Delusions are thought to result from
faulty interpretations of events, and cognitive therapy is used to help the patient to identify and correct
CBT techniques
In CBT, patients are encouraged to trace back the origins of their symptoms in order to get a
better idea of how the symptoms might have developed. They are also encouraged to
evaluate the content of their delusions or of any internal voices they hear, and to consider
ways in which they might test the validity of their faulty beliefs. Patients might also be set
behavioural assignments with the aim of improving their general level of functioning.
The learning of maladaptive responses to life's problems is often the result of distorted
thinking by the schizophrenic, or mistakes in assessing cause and effect (for example
assuming that something terrible has happened because they wished it).
During CBT the therapist lets the patient develop their own alternatives to these previous
maladaptive beliefs, ideally by looking for alternative explanations and coping strategies that
are already present in the patient's mind.
Outcome studies
Outcome studies measure how well a patient does after a particular treatment, compared
with the accepted form of treatment for that condition. Outcome studies of CBT suggest that
patients who receive cognitive therapy experience fewer hallucinations and delusions and
recover their functioning to a greater extent than those who receive antipsychotic medication
Drury et al. (1996) found benefits in terms of reduction of positive symptoms and a 2550%
reduction in recovery time for patients given a combination of antipsychotic medication and
A subsequent study by Kuipers et al. (1997) confirmed these advantages, but also noted that
there were lower patient dropout rates and greater patient satisfaction when CBT was used
in addition to antipsychotic medication.
Effectiveness of CBT
Supporting research ­ Research has tended to show that CBT has a significant effect on
improving the symptoms of patients with schizophrenia. For example Gould et al. found hat all seven
studies in their metaanalysis reported a statistically significant decrease in the positive symptoms of
schizophrenia after treatment.
How much is due to the effects of CBT alone? ­ Most studies of the effectiveness of CBT have
been conducted with patients treated at the same time with antipsychotic medication. It has been
difficult, therefore to assess the effectiveness of CBT independent of antipsychotic medication.
Appropriateness of CBT

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Negative symptoms ­ CBT for schizophrenia works by trying to generate less disturbing
explanations for psychotic experiences, rather than trying to eliminate them completely. Negative
symptoms may well serve a useful function for the person and so can be understood as `safety
behaviours'. For example, within a psychiatric setting, the strong expression of emotions might lead to
increases in medication or hospital admission. Similarly, inactivity withdrawal might be seen as a way
of avoiding making positive symptoms worse.…read more

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Effectiveness of psychodynamic therapy
Supporting research ­ Malmberg and Fenton (2001) argue that it is impossible to draw definite
conclusions for or against the effectiveness of psychodynamic therapy. In fact the Schizophrenia
Patient Outcome Research Team (PORT) has even argued that some forms of psychodynamic
therapy are harmful for patients with schizophrenia. Despite this, a Meta analysis of 37 studies
(Gottdiener, 2000) concluded that psychodynamic therapy was an effective treatment for
schizophrenia.…read more

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