Starter…. Similarities Differences Biological Explanation of Schizophrenia Cognitive Explanation of Schizophrenia

Biological Explanation of Schizophrenia Similarities Differences Biological Explanation of Schizophrenia deemed deterministic as they provide complete reasons for the psychosis, however fail to consider free will as many would argue that there is a considerable amount of choice regarding behaviours and thoughts. take into account the role of the family which is a vital aspect to consider when looking at the development of schizophrenia. Both explanations explore family influence in order to discover the origin of the disorder and how it builds a foundation over the years until the illness triggers highly scientific - OFR, what methods are used? the biological approach is reductionist as it focuses fully on the bodily and natural causes, ignoring any environmental aspects they may contribute to the development of schizophrenia biological explanation allows us to deal with schizophrenia as it has helped in the development of various treatments which have been proven highly successful in controlling the unbearable symptoms of schizophrenia Explanation is quite generic but scientific – factual Cognitive Explanation of Schizophrenia is more credible and explores more than one factor that could effect the initiation of schizophrenia – cognitive processes and the environment and some elements of bio Considers (to a point) ind diffs Explanation is quite theoretical and cant see it

The Cognitive Treatment of Schizophrenia Cognitive Behavioural Therapy (CBT) Cognitive behavioural therapy (CBT) can help people with schizophrenia to cope better with the symptoms of hallucinations or delusions. Distressed text effect (Basic) To reproduce the text effects on this slide, do the following: On the Home tab, in the Slides group, click Layout, and then click Blank. On the Insert tab, in the Text group, click Text Box. On the slide, drag to draw a text box. Enter text in the text box, and then select the text. On the Home tab, in the Font group, select Arial from the Font list, select 77 pt. from the Font Size list, and then click Bold. Select the text box. Also on the Home tab, in the Clipboard group, click Copy. Press DELETE to delete the text box. Also on the Home tab, in the Clipboard group, click the arrow below Paste, and select Paste Special. In the Paste Special dialog box, select Paste, and then under As, select Picture (PNG). Select the picture. Under Picture Tools, on the Format tab, in the Picture Styles group, click the Format Picture dialog box launcher. In the Format Picture dialog box, click Artistic Effects in the left pane, in the Artistic Effects pane, click the button next to Artistic Effect, and then click Pencil Grayscale (first row). Also in the Artistic Effects pane, in the Pencil Size box, enter 1. Also In the Format Picture dialog box, click Picture Corrections in the left pane, in the Picture Corrections pane, under Brightness and Contrast, in the Contrast box, enter 25%. On the Home tab, in the Clipboard group, click Copy. Select the picture. Under Picture Tools, on the Format tab, in the Adjust group, click Artistic Effects, and then click Pencil Sketch (first row). Also on the Format tab, in the Adjust group, click Corrections, and then click Picture Corrections Options. In the Format Picture dialog box, click Picture Corrections in the left pane, in the Picture Corrections pane, under Brightness and Contrast, enter 37% in the Brightness box and 100% in the Contrast box. Also in the Format Picture dialog box, click Picture Color in the left pane, in the Picture Color pane, under Recolor, click the button next to Presets, and then click Sepia (first row). Also in the Format Picture dialog box, click Size in the left pane, in the Size pane, under Size and rotate, in the Rotation box, enter 353°. To reproduce the background on this slide, do the following: On the Design tab, in the Background group, click Background Styles, and then click Format Background. In the Format Background dialog box, click Fill in the left pane, and then in the Fill pane, click Picture or texture fill. Also in the Fill pane, click the button next to Textures, and then click Recycled Paper. On the Home tab, in the Drawing group, click Shapes, and then under Rectangles click Rectangle. On the slide, drag to draw a rectangle. Select the rectangle. Under Drawing Tools, on the Format tab, in the Size group, enter 7.5” in the Height box and 10” in the Width box. Also on the Format tab, in the Arrange group, click Align, and then do the following: Click Align to Slide. Click Align Middle. Click Align Center. Also on the Format tab, in the Shape Styles group, click Shape Outline, and then click No Outline. Also on the Format tab, in the Shape Styles group, click the Format Shape dialog box launcher. In the Format Shape dialog box, click Fill in the left pane, in the Fill pane, click Gradient fill, and then do the following: In the Type list, select Linear. In the Angle box, enter 90°. Under Gradient stops, click Add gradient stops or Remove gradient stops until three stops appear in the slider. Also under Gradient stops, customize the gradient stops as follows: Select the first stop in the slider, and then do the following: In the Position box, enter 0%. Click the button next to Color, click More Colors, and then in the Colors dialog box, on the Custom tab, enter values for Red: 74, Green: 69, and Blue: 42. In the Transparency box, enter 55%. Select the next stop in the slider, and then do the following: In the Position box, enter 50%. Click the button next to Color, click More Colors, and then in the Colors dialog box, on the Custom tab, enter values for Red: 149, Green: 138, and Blue: 85. In the Transparency box, enter 90%. Select the last stop in the slider, and then do the following: In the Position box, enter 100%. Click the button next to Color, under Theme Colors, click White, Background 1 (first row). In the Transparency box, enter 50%. On the Home tab, in the Drawing group, click Arrange, and then click Send to Back.

What is CBT? Cognitive behavioural therapy (CBT) is based on the idea that most unwanted thinking patterns, and emotional and behavioural reactions are learnt over a long period of time.

Psychological Treatment; CBT The CBT approach to treatment differs slightly from conventional CBT methods. The aims of this therapy are: To challenge and modify delusory beliefs To help the patient to identify delusions To challenge those delusions by looking at evidence To help the patient to begin to test the reality of the evidence For example, you may be taught to recognise examples of delusional thinking in yourself eg – thinking that people what to kill you. You may then receive help and advice about how you can avoid acting on these thoughts eg – Rationalizing that people have no reason to want to hurt you. Encouraging you to engage with people in meaningful ways. Allowing opportunities to practice these new skills and share your experiences and reflect on how it felt to engage in positive social interactions.

Length of treatment Most people will require between five to 20 sessions of CBT over the space of six to 12 months. CBT sessions usually last for about an hour Been shown to be effective for: reducing the positive symptoms of schizophrenia, for reducing relapse and for enhancing recovery when schizophrenia is diagnosed early

An example of a delusional belief Event Overhearing someone saying “I know what’s on your mind” Interpretation Everyone can read my thoughts Feeling Paranoid, scared and believing that others will attack me for my thoughts Behaviour Take evasive action – avoiding situations that will bring me into contact with others

Psychological Treatment; CBT Everyone can read my thoughts CBT strategies try to challenge & help modify delusory beliefs Identify delusions Challenge evidence on which delusions are based Design ‘experiments’ to test reality of this evidence Drawing diagrams for patients to show links between thinking, behaviour and emotions Normalising strategies = where patient is taught to understand the nature of schiz. Symptoms Challenge ‘catastrophising’ beliefs about schizophrenia Help patient feel that symptoms are understandable and ‘normal’ Overhearing someone saying “I know what’s on your mind” “think of something now and see if I can read your thoughts” Chadwick & Lowe (1993) – significant reductions in delusions in 10 out of 12 patients Helps 70% of patients although other 30% may deteriorate (Kingdon & Turkington, 1996)

Turkington et al (2004) Purpose is to help patients make sense of their environment including delusions and hallucinations Understanding origins of symptoms can be crucial – if a patient hears voices and believes they are demons, naturally they become afraid. CBT can offer a way / strategy to reduce this anxiety…. What else is this therapist offering / providing?

Other research Sensky et al (2000) found that CBT was effective in treating schizophrenia patients who hadn’t responded to drug treatment effective for +ive and –ive symptoms patients continued to improve 9 months after treatment had ended Lomas talking about Lynch, Laws & McKenna NHS article – NICE research Favrod 2006 Bradshaw 1998 – the case of Carol Read the different pieces of research and complete hand out

Evaluation Evaluation of CBT Don’t sit passively!! Make notes… some good evaluation points are here…

Some Evaluation of CBT Gould et al. carried out a meta-analysis of seven studies and found a significant decrease in the positive symptoms of Sz. Kuipers et al. found that when combined with antipsychotic drugs there was a lower drop out rate and greater patient satisfaction. Allows people to function more normally with symptoms, preventing Learned symptoms from developing. Can be used in conjunction with other therapies Improves symptoms, recovery and relapse rates No side effects CBT for Sz works by generating less distressing explanations for negative experiences rather than eliminate them completely. Shown to be incredibly effective Doesn’t work for everybody i.e. not suitable when the patient are deluding as they cannot fully engage with the therapy Not very rational to teach patients to see life through rose coloured spectacles Reliant on the patient committing to the therapy Expensive and time consuming

Homework Some: On the blog is the Bradshaw complete article If you would like to use Case Studies as a method for Clinical this is your study you need to refer to All: Complete reading around what we have covered this week Dig out any notes from AS on animal research for next week Leaflet  Passport to Success Some: Resitting: past paper on the Blog due in week before Easter

Extension Apply your knowledge: You have a friend that you believe has schizophrenia. You have been asked to explain to them why they might have schizophrenia. They also ask you about which treatments you would recommend. Which explanations / treatments would you share with them? Are there any that you would leave out?