Cognitive-behavioural Drug therapy Psychodynamic therapy Social interventions Family interventions Electroconvulsive therapy (ECT) Prefrontal lobotomy This is where patients develop cognitive strategies to prevent the onset of schizophrenia before it begins. Discovered in the 1950s, these are are still widely used today. Examples include antipsychotics Focus upon bringing repressed emotions and thoughts to the patient’s consciousness. These make use of behavioural techniques, and assume that social factors affect the course of schizophrenia. This is where lesions are made in the frontal lobes of the patients brain. Electric shocks are sent through patients’ bodies in an attempt to ‘rewire’ body. This is where family members are briefed thoroughly on the causes and symptoms of schizophrenia, and are provided with coping skills. Tarrier (1987) found that people with schizophrenia often identify ‘triggers’ before their schizo’pa begins, and thus develop coping strategies to help with their negative thoughts. Wing and Brown (1970) compared female in patients on positive and negative behavioural symptoms. Found marked differences between those women on stimulating wards and those that were not. Moniz (1936) claimed a high success rate during the 1930s. Lasting twenty years longer than lobotomies, this was used on 80% of cases until the introduction of drugs. Fromm-Reichmann (1948) suggested that they had successfully updated Freud’s techniques. Julien (2005) found that they allow people with schizophrenia to live outside of institutional care. Research on expressed emotion (EE) by Brown et al (1989) has shown that certain aspects of family life can affect schizophrenia. They found that family intervention has reduced the ate of relapse significantly, but also improve compliance when patients are taking medication. These do not seem effective against negative symptoms. They can reduce symptoms, but symptoms return if the treatment stops. About 30% of cases do not respond to them. No evidence that such treatment alleviated (made better) symptoms of schizophrenia. Actually produced severe cognitive and emotional impairment. As with lobotomies, this had unpredictable and often severely damaging effects. Freud and his successors have been supported by very little , with Tarrier (1990) suggesting that such methods actually over stimulated schizop’ics and promoted relapse. Not necessarily related to ‘real life’. However, social training can improve individuals’ competence and assertiveness in social situations (Birchwood et al (1999) Overwhelming support for family intervention. Reduces the rate of relapse significantly. Studies have shown this therapy to be effective, with Kuiper (1997) finding that lower hospitalisation rates and improved attention are just some results. Effective with drug therapy.

How effective are therapies for schizophrenia? Very effective How effective are therapies for schizophrenia? Biological Psychological Key Point Evidence Very ineffective Evaluation

Mark Success (What went well…): Target: (Even Better If…): Think/Tip/Challenge: “Schizophrenics do not require biological therapies, just psychological ones”. How far do you agree with this statement? (9+16 marks) Mark

How effective are these therapies? Some have criticised this type of therapy for not relating to ‘real life’. Focussing on women in a ward for example, might not yield results that can be generalised. Often these can produce distressing and sometimes irreversible side effects from drowsiness to severe facial tics. Due to the nature of schizophrenia, patients will often have poor social skills and problems wit everyday living. ‘Milieu therapy’ is a social skills programme that looks to support patients in institutional care. These therapies can help people develop the skills and confidence to live in the community. In the first stages after diagnosing schizophrenia, drugs are the most important treatment option.