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Outline and evaluate psychological therapies for schizophrenia

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Outline and evaluate psychological therapies for schizophrenia The underlying idea of cognitive behaviour therapy (CBT) is that people with mental disordesr have irrational and distorted ways of thinking. The goal of CBT is to provide an alternative to the often bizarre psychotic thoughts and feelings that the person with schizophrenia experiences. Although there are several forms of CBT, all have the aim of modifying hallucinations and delusional beliefs. CBT attempts to challenge (and to reality test) the client's interpretation of their hallucinations and to propose alternative explanations. One form of CBT is called Coping Strategy Enhacement (CSE). One of the ideas behind this approach is the finding that the majority of people who experience delusions and/or hallucinations report using coping strategies (Tarrier 1987). Such strategies include drowning-out voices by turning up the television set, use of distraction, withdrawal from social contact and self-talk. CSE aims to develop the client's coping strategies in order to reduce the frequency, duration and intensity of the psychotic symptoms. ...read more.


Two reasons that CBT is appropriate for people with schizophrenia include: Many symptoms of schizophrenia are cognitive in nature, for example, delusions, hallucinations and disorganised speech, and CBT directly targets cognitive processes. Many people with schizophrenia use coping strategies to control their delusions and hallucinations, so it makes sense for a therapy to build on these coping strategies. However, people with schizophrenia generally do not realise they have a problem, and thus lack insight into their condition, a further limitation of CBT's appropriateness. CBT does not take into account the biological factors (e.g. biochemistry), thus it is doubtful whether CBT on its own would be effective. CBT involves the active co-operation of the client - thus is avoids the criticism made against drug therapy, that the client is a passive recipient of treatment. Family therapy focuses on the social dynamics within the family. The aim is to reduce the level of negative expressed emotion in the family. ...read more.


Birchwood and Jackson (2001) found that the relapse rate over 12 months was between 25% and 33% for those receiving family therapy, compared to 60% for those receiving routine treatment. It is unlikely that family therapy can provide a cure for schizophrenia. Although there is convincing evidence that family therapy benefits people with schizophrenia, it does not make their social functioning comparable to that of healthy controls. 65% of patients with schizophrenia return from hospital to their families. Thus the role of the family is crucial. Family therapy is an appropriate way of establishing a secure family environment. There is evidence that expressed emotion within the family increases the risk of relapse therefore a therapy that focuses on family dynamics has obvious value. People with schizophrenia are socially isolated - and a therapy that emphasises social functioning addresses this important issue. However, family therapy probably doesn't work on its own, but needs to be used in conjunction with drug therapy. Many patients with schizophrenia do not belong to a functioning family, hence there are limitations to its appropriateness. ?? ?? ?? ?? ...read more.

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