Outline and evaluate the psychological therapies for schizophrenia

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AO1 - CBT + CSE

CBT

  • 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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