Psychotherapy Treatments for Schizophrenia- ESSAY PLAN

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Psychotherapy Treatments for Schizophrenia
Introduction: > An umbrella term used to describe many therapies such as cognitive
therapy, CBT and psychoanalysis
> It was once thought to be inappropriate for schizophrenic patients as it
required patients to be able to express their feelings and communicate
effectively which was hard for those with schizophrenia who are in a
confused state of mind with a lack of insight into their disease
> However there is now developing evidence which supports psychological
rather than biological processes as being responsible for the maintenance
of symptoms, in particular delusions and hallucinations
> Therefore, psychotherapies such as CBT have been developed to target
challenge these dysfunctional thoughts associated with the behaviour
CBT: > Designed to help individuals who have recently been released from hospital and so
require support in preventing relapse and adjusting to everyday life
> Taught skills in both an individual and group setting, such as:
Learning to identify signs of relapse and what to do in those circumstances
Learning to deal with negative feedback from others and to resolve interpersonal
> A second from of CBT has been used to give patients skills and strategies to cope
irrational thoughts, delusions and hallucinations e.g. challenging the bias of
hallucinations being threatening
CSE: > Coping strategy Enhancement, a form of a CBT programme
> It has been found that many schizophrenics use ineffective coping strategies when
dealing with psychotic symptoms
> Niyani reported many coping strategies are ineffective with some increasing the
frequency of hallucinations Niyani referred to these as safety behaviours> they
prevent the patient from disconfirming their belief that the hallucination is
> CSE is used to help the patient to develop or improve already existing coping
strategies and involves 6 steps:
1. Assess the content of the psychotic content (how many voices? What are they
2. Assess the emotional response
3. Assess the person's thoughts that result from the emotional response
4. Assess any prior warning
5. Assess the individual's coping strategies
6. Get the individual to rate the coping strategy in relation to its effectiveness
Evaluation of CSE: > Tarrier: investigated the use of coping strategies during psychotic
episodes. 25 schizophrenic patients of which it was found 1/3
triggers to the symptoms, 75% reported major distress, 1/3 reported
major disruption in thinking and behaviour and 75% disclosed the use

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BUT relies on effective communication from
patients which isn't often possible with schizophrenics, small sample
size could affect validity of results
Evaluation of Psychotherapy: > Studies have shown that CBT enables patients to cope
discharged from hospital
> The improvement in social and cognitive skills gained from
CBT is still evident 24 months after entering the
> More effective when used as an adjunctive therapy with a
primary treatment which in this case would be
neuroleptics.…read more


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