Psychological Therapies of Schizophrenia

Cognitive Behavioural Therapy Aims: Challenge irrational thoughts and distorted beliefs Provide an alternative to psychotic thoughts and feelings schizophrenics experience Challenge and reality test the clients interpretation of their hallucinations

Another form of CBT Tarrier – Coping strategy enhancement. Aims to develop the clients coping strategies ‘The majority of people who experience + symptoms report using coping strategies (withdrawal from social contact) CSE reduces the frequency and intensity of psychotic symptoms

Support Zimmerman et al. CBT is more effective for treating + symptoms than having no treatment. Appropriate – Targets cognitive processes and most symptoms are cognitive in nature. Tarrier – reviewed 20 studies and found consistent evidence that CBT reduces symptoms in the short term. Gould et al. reviewed 7 studies and found a statistically significant decrease in + symptoms after treatment

Meta-Analysis Meta-analysis’ take many studies into account. This amount of studies allow us to draw more reliable conclusions The studies involved in meta-analysis’ will all have different aims, this means they are not directly comparable, which may stop valid conclusions from being drawn.

Criticisms Some studies show no benefits after a year of CBT. Research is lacking in evidence that CBT reduces relapse rates. CBT wouldn’t be effective on its own as it doesn’t take biological factors into account. CBT only reduces positive symptoms. Most schizophrenics don’t realise they have a problem and so lack insight into their condition.

Synoptic Focuses too much on irrational thoughts and feelings as being a cause for schizophrenia (nurture) and so ignores the possible role of neurotransmitters (nature) Reductionist – ignores genetic and environmental factors in causing schizophrenia and puts the disorder down to cognitive processes.

Family Therapy Aims: Reduces the level of negative expressed emotion which is a main factor in causing relapse rates. Requires the involvement of several family members as well as the schizophrenic. Falloon et al. devised a form of family management to be used when the patient returned home from hospital. Teaches everyone in the family how to be constructive, undemanding and empathic with each other and with their schizophrenic relative.

Falloon et al. Compared schizophrenics receiving Family therapy with schizophrenics receiving individual therapy from a therapist. They found relapse rates were significantly lower amongst those receiving family therapy. Only 11% returned to hospital within one year of having family therapy compared with 50% of those having individual therapy

Support FT helps to prevent patient isolation as many other therapies isolate the patient socially and so the fact that this therapy emphasises social functioning makes it appropriate.

Criticisms Family therapy is unlikely to cure schizophrenia, although it has been proven to benefit patients, it doesn’t make their social functioning comparable to that of healthy controls Many patients with schizophrenia don’t belong to a functioning family; hence there are limitations to family therapies appropriateness

Synoptic Nurture Reductionist