On October 23rd, 2014, we updated our
By continuing to use LinkedIn’s SlideShare service, you agree to the revised terms, so please take a few minutes to review them.
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. asz 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
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
of family psychoeducation it may mean that the family is becoming better at
detecting warning signs that the illness is getting worse and bringing their relative
to hospital, this meaning that the patient is now getting care/attention from their
family that they did not previously, which is a positive outcome.