Psychological Therapies - Schizophrenia.

Social Intervention.

Social factors can affect the course of schizophrenia.

Wing and Brown (19,20) compared female in-patients. social changes were introduced (including promoting self esteem and personal control. Improvements were observed in one third.

Milieu Therapy.

Used while in institutional care.

Aims to include patients in decision making.

Can include token economy, privileges are earned. For example, by refraining from bizarre behaviour. Rewards can be visitors, going out, watching TV, etc.

Evaluation.

Therapy effective in helping achieve independence.

Token economies effective, this is shown in Dickerson et al's (2005) meta analysis.

Less effective when patients get used to rewards and stop following behaviour.

Token economy focuses on only a few symptoms. It does not address cognitive symptoms, such as delusions and hallucinations. Only learn to imitate normal behaviour.

Ethical issues related to the desired behaviours. They are decided by the psychologist.

Patients tend to be treated in community nowadays, Token economy is less effective in this setting.

Token economy only produces short term changes.

Social Skills Training.

Developed to modify or improve the social behaviour of sufferers.

Halford and Hayes (19.92) produced a training programme including:

- Conversational skills, 

- assertion,

- conflict management,

- medication management,

- time use,

- and employment skills.

Evaluation.

Critics of this therapy suggest the training does not…