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  1. 1. Outline and evaluate psychological treatments for schizophrenia - 8 + 16 Cognitive behavioural therapy (CBT) can be used to treat schizophrenia (sz). CBT is a therapy designed to change the way someone thinks, feels, and behaves, in order to change the faulty and distorted thoughts that supposedly cause the onset of sz. It helps patients with sz to learn how to form more realistic interpretations of events, so they can distinguish between hallucinations/delusions and reality. This can then be used to develop coping techniques for these positive symptoms, and it may help them to identify triggers for their symptoms in order to prevent future episodes. E.g. a sz may see someone and believe they are going to attack them, feel scared, and then behave in response to that. CBT may be able to change this chain of events to create more realistic interpretations - e.g. seeing someone, thinking they are just walking past, feel calm, and so do nothing. Research studies such as Gumley et al’s have shown CBT to be significantly effective in reducing both relapse rates and hospital admissions. They gave 144 sz patients either their normal treatment, or CBT in addition to their normal treatment, and found that after 12 months 15% of the CBT group were admitted to hospital compared to 26% of the none CBT group, and 18% relapsed compared with 35% in the none CBT group. This suggests CBT to be a very effective treatment, however not everyone with sz may benefit from CBT. If patients are suffering so severely that they do not have the mental/cognitive capacity to follow along with the group/therapist, then they will not be able to benefit from CBT until their symptoms are controlled by drugs first. This means that CBT is unlikely to be the option of treatment that is used first, and it is unlikely to be as effective when used alone, without drug treatments alongside. There are also issues with measuring effectiveness, because although studies tend to measure reduction of symptoms and hospital admissions, there may be other, more relevant ways of measuring effectiveness depending on the patient, such as better social functioning or the ability to hold down a job, because factors such as these are extremely important when assessing a patients quality of life. Family intervention is another psychological therapy used to treat sz. Family psychoeducation was developed by Anderson, and it teaches patients and their families about the nature and causes of the disorder, management strategies, and skills needed to avoid relapse. This is done with the idea that patients returning to a supportive home environment that is optimal for recovery, are less likely to relapse. This treatment is not based around the idea that the family caused the onset of the disorder, but that they can help significantly in their relatives recovery, and so the family is assumed to be functional unless proven otherwise. Family psychoeducation has shown to significantly reduce relapse rates Baucom found that relapse rates in patients who had the therapy alongside medication were around 15% per year, while in patients on just medication, or medication and a different therapy were around 30-40%. However, like with CBT, it can be difficult to measure the effectiveness. Normally if rates of hospitalisation after a therapy increased, it would be a sign that it was ineffective, but in the case
  2. 2. of family psychoeducation it may mean that the family is becoming better at detecting warning