CBT, Family Therapy and Token Economy

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  • Created by: FatCat3
  • Created on: 02-03-23 11:38
what is cbt based on the assumption of?
that s patients can be helped by identifying and changing faulty cognitions
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what is the main psychological treatment and who recommends it?
CBT, NICE recommend all patients with s to do this
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what does CBT aim to do?
change maladaptive thinking and improve symptoms
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how is CBT used to help the sufferer?
CBT helps understand that their beliefs of being controlled (delusions) and other faulty interpretations of events are irrational beliefs
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what CBT is recommended to schizophrenics?
CBTp- cognitive behavioural therapy for psychosis
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what is the process of CBTp? (includes 7 steps)
1.CBT takes place once every 10 days for 12-16 sessions (NICE recommends 16)
2.CBTp can be delivered in groups in 1-1 sessions
3.Aim is to establish links between sufferers thoughts, feelings, actions and their symptoms, -
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-improving their general level of functioning by monitoring their thoughts in relation to symptoms, ppl can consider alternative ways fro explaining how they feel and behave the way they do, in which patients are taught signs of relapse
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4. drawings are often used to display links between sufferers thoughts, actions and emotions
5.cognitive techniques developed between patient and therapist such as:
.distraction form intrusive thoughts,-
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-.challenging intrusive thoughts to disprove it/base it on reality, .high/low social activity to distract them from thoughts, .using relaxation techniques ie meditation, muscle relaxation
6.relies on pp taking active part, they are gibes HW -
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-between sessions, like keeping a diary of their delusions, then hw might be trying out ways of coping/learning from therapy
7.drug therapy introduced, therapist lets patients develop alternatives to only previous maladaptive-
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-explanations ie looking for alternative explanations and coping strategies present in pp minds
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name evaluation of CBT
+those who go CBTp suffer fewer hallucinations/delusions and recover to greater degree then drugs alone, Drury et al found 25-50% reduction in recoevry time for patients on drugs+cbt
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+many benefits from using cbt+drugs, tarrier et al found ppl w s received 20 sessions of CBT 1-1 w DT, followed by 4 booster sessions made significant improvements then sufferers receiving DT alone or supportive counselling (+kuipers et al-
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-pp had low drop out rates and high satisfaction when CBTp w drugs was used)
-using drugs and therapy is hard to distinguish apart
-hard for patients to continue feeling better after-
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-therapy stopped
+CBTp has fewer side effects than drug therapy ie sufferer not at risk of tardive dyskinesia or diabetes (-more expensive and time consuming)
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what form is family therapy?
a form of psychotherapy
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is it used alone?
no its typically used alongside drugs
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what it is it based on the assumption of?
based on idea that dysfunctional families plays a role in s, and that communication and altering relationships with fam should help ppl in s to recover, and so treatment involves whole fam
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what does NICE say about it?
NICE said FT should be offered to all individuals suffering from s that a live with or have close contact with fam and it should be priority as this can be persistent in their symptoms
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what are the main aims of FT?
-to improve positive ie praise and decrease negative forms of communication ie criticism
-increase tolerance levels and decrease criticism levels between fam
-decrease feelings of guilt/responsibility for causing s
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-reduce burden/stress of care for fam
-enhance fam ability to anticipate and solve problems
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how does FT work? (6 steps)
1.therapist meets with patients and close fam members who are encouraged to talk openly about patient symptoms, behaviour and progress
2.taught to support each other and be caregivers w each person given a specific role in relation to s process
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3.emphasis on openness w no details remaining confidentiality, but boundaries are set prior
4.set for a specific amount of time, 3 mnths-1 year and for at least 10 sessions
5.reducing levels of ee within fam, as ee can increase relapse
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6.provides foam with info on s, finding ways to support the individual and resolve any practical problems, ensuring sufferer keeps medical appointments and takes their medication
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name the evaluations
-based on psychological explanations, neglects other explanations
+Pharoah et al conducted meta analysis of 53 studies from purpose, Asia and US, compared outcomes from FT to standard care ie drugs,-
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-found ft increased compliance with medication and there was a reduction in relapse, treatment more effective (-less to do w improvements and more based on medication importance)
-nature of therapy is very difficult to do, it may cause-
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-problems due to the emphasis on openness, cant change 20 year mindsets with 10 sessions (+practical issues, harder to get fam together at the same time)
+cost effective as well as decreasing relapse rates-
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-reduces the need for hospitalisation and so ft can educate fam to help manage patents medication regime, reducing need for medical help, therefore prove as cost effective(+s commission estimates that ft cheaper then rugs by £1004 aa patients over 3 year
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what is the token economy?
it is a behaviourist approach to the management of s where tokens are awarded for desired behavioural change
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what is it aimed at changing?
changing s such as low motivation, poor attentions +social withdrawal
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who is it mainly used on?
for hospitalised patients to set them for their lives, giving them independence once they leave the hospital
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how does the token economy work? (includes 5 steps)
1.clinicians set target behaviours that they believe improves the patient’s engagement in their daily activities ie patient brushing their hair, or a more socially orientated behaviour
2.tokens are then rewarded whenever a patient-
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-engages in one of the target behaviours which can be later exchanged for rewards
3.the patient will then become more engaged in the desirable behaviours as they associate these behaviours with rewards/privileges
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4.the tokens are neutral, to give the neutral token value the behaviour needs to be repeatedly shown alongside reinforcing the stimuli (the reward), c.c as token paired with desirable behaviours
5.during early stages of treatment, frequent-
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-exchange periods mean patients are quickly reinforced and target behaviours can then increase in frequency, effectiveness decreases if more time passes by between behaviour being shown and receiving a token
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name the evaluation
-will stop working once token is taken away, the behaviour won't happen after token isn't there
-not practical, one out of hospitalisation someone will have to provide rewards and might not have good enough rewards for behaviour to be carried out
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for evals^- leads to an increase in relapse rates
-ethically immoral, humiliating schizophrenics and clinicians then control privacy or food of s sufferers that is their basic human right
+increasing independence of schizophrenics-
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which not only helps sufferers but also helps hospital staff help patients who need more support then schizophrenics as they will be able to complete more tasks on their own, reducing staff/patient injuries and staff absenteeism
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Other cards in this set

Card 2

Front

what is the main psychological treatment and who recommends it?

Back

CBT, NICE recommend all patients with s to do this

Card 3

Front

what does CBT aim to do?

Back

Preview of the front of card 3

Card 4

Front

how is CBT used to help the sufferer?

Back

Preview of the front of card 4

Card 5

Front

what CBT is recommended to schizophrenics?

Back

Preview of the front of card 5
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