CBT tries to focus on the faulty cognitions of the brain and changing the beliefs and thoughts of a person
Main assumption: distorted beliefs tend to cause maladaptive behaviour
In CBT patients are asked to trace back to the origins of their symptoms
The client is taught to recognise their own examples of delusional thinking whilst challenging the patient's interpretation of events
Most people will require between 8-20 sessions over the space of a 6-12 month period
CSE
Coping strategy enhancement (CSE) is based upon the research of Tarrier et al who found that sz sufferers can identify triggers to psychotic symptoms and can come up with a coping methos of the distress they feel
73% of people involved in the study fount the strategies were helpful
In therapy clients are helped through problems ,given homework tasks and other tactics to help reduce the symptoms of Sz
Tarrier et al (1993) found that CSE helped alleviate positive symptoms in contrast to waiting group without treatment
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AO2 - CBT + CSE
Support
Drury et al (1996) found benefits in terms of the reduction of positive symptoms
25-50% reduction in recovery time for patients with a combination of both anti-psychotics and CBT
Tries to seek the cause of their condition rather than just treating the symptoms
Criticisms
CBT is effective when combined with drugs but its questionable how effective the therapy would be on its own
Requires a lot of commitment and dedication from the patient therefore might not be appropriate for everyone
Kingdon and Kirschen (2006) found that many patients were not suitable for CBT because they could not fully engage with the therapy
Believed that CBT is only appropriate for those who are capable for having reasonable insight into their disorder, in the case of some patients their delusions are supported by so much evidence that it can be difficult for them to be disproved or told otherwise
CSE - Tarrier study was very well controlled so there was high reliablity, however in 45% of his sample of 49 refused to co-operate or dropped of the trial so the so the small sample size reduces the reliability and results are difficult to generalise to the general public
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AO1 - Family Intervention
Family intervention attempts to make family life less stressful and reduce the chances of relapse
Based on research by Brown et Al into expressed emotion, FI seeks to reduce the levels of expressed emotion and stress and increase the capacity of relatives to help solve problems
Strategies incluce forming alliances with relatives of the sz sufferer as well as enhancing relatives' ability to anticipate and solve problems
FI is often used with both drug treatment and outpatient clinical care
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AO2 - Family Intervention
Support
NICE (2009) carried out a meta-analysis involving 32 studies and 2500 patients, finding a reduction in the hospital admissions during treatment and in the severity of symptoms of those using FI compared to those in standard care.
FI condition relapse rate = 26% whereas the control group relapse rate = 50%
Criticisms
Most evidence comes from studies conducted outside the UK so has cultural limitations and difficult to generalise to other cultures
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