Outline and evaluate two or more therapies used in the treatment of schizophrenia.

Treating Schizophrenia

‘Therapies can be time-consuming and, in some cases, uncomfortable for the client. It is, therefore, very important to offer the most appropriate and effective type of treatment.’

Different people choose different therapies for schizophrenia because the difference in treatments is so vast with different levels of intensity and effectiveness. Treatments are usually selected by which the patient feels most comfortable with. There are two main types of therapies, Biological and Psychological.

Antipsychotic medication is a biological therapy. These are drugs that are effective in treating the most disturbing forms of psychotic illness such as schizophrenia and bipolar disorder. Antipsychotic medication helps the person with the disorder function as well as possible in their life. Conventional antipsychotics (for example chlorpromazine) are used primarily to combat the positive symptoms of schizophrenia such as hallucinations. The basic mechanism of conventional antipsychotics is to reduce the effects of dopamine and so reduce the symptoms of schizophrenia, hence their alter ego, dopamine antagonists. They bind to dopamine receptors but do not stimulate them, thus blocking their action. By reducing stimulation of the dopamine system in the brain, antipsychotics can eliminate the bad symptoms such as hallucinations. Atypical antipsychotic drugs (such as clozapine) also combat these positive symptoms but there are claims that they also have beneficial effects on negative symptoms as well. These antipsychotics also act on the dopamine system but are thought to block serotonin receptors in the brain as well. They help by only temporarily occupying the dopamine receptors and then rapidly dissociating to allow normal dopamine transmission.

It is commonly thought that conventional antipsychotics are more effective than atypical ones. This is due to the studies conducted into them showing that in comparison to a placebo pill they are significantly effective. However the is a possibility that the patient may experience some undesired side effects such as tardive dyskinesia. This is when the patient gets uncontrollable movements of the lips, tongue, face, hands and feet. About 30% of people taking antipsychotics will develop tardive and it is irreversible in 75% of those cases. As well as this, the claim that atypical antipsychotics are particularly effective with the ...

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Although the use of antipsychotic drugs is crucial in the treatment of schizophrenia, many people do not experience the benefits they offer, normally due to their side effects. As a result, some believe that additional psychological treatments, also known as psychotherapy. The cognitive behavioural therapy (CBT) follows the assumption that people often have distorted beliefs which influence their behaviour in maladaptive ways. In the therapy, patients are encouraged to trace back the origins of their symptoms in order to get a better idea of how the symptoms might have developed. As well as this, they are also encouraged to evaluate the content of their delusions to consider ways in which they might test the validity of their faulty beliefs. Next the patients would be given behavioural assignments with the aim of improving their general level of functioning. The learning of maladaptive responses to life’s problems is often the result of distorted thinking by the schizophrenic.

Research over time suggests that CBT has a significant effect on improving the symptoms of patients with schizophrenia, however the majority of studies of the effectiveness of CBT have used schizophrenics who are also taking antipsychotic drugs. This leaves the question, how much of the improvement is due to CBT alone? Also, CBT for schizophrenia works by trying to generate less distressing explanations of psychotic experiences, rather than trying to eliminate them completely. The negative symptoms shown by a schizophrenic may well serve a useful function for the person and so can be understood as safety behaviours and could cause potential damage. Lastly, it has been found that CBT doesn’t actually work for all Schizophrenics, Kingdon and Kirschen found that many patients were not deemed suitable for CBT because psychiatrists believed that they would not fully engage with the therapy.

Peer Reviews

Here's what a star student thought of this essay

sydneyhopcroft

31st of Aug 2012

Quality of writing

The Quality of Written Communication is very high. It is clear this candidate has taken great care in their written expression and have ensured that errors in grammar, spelling and punctuation are kept to a minimum. The use of psychological terminology will indicate to the examiner the candidate is comfortable with analysing psychology using the language of the professionals.

Level of analysis

The level of Analysis is brilliant, and is indicative of an A grade candidate for A Level. There is a balanced discussion about the positives and negatives of both treatments, biological and psychological, with a number of evaluative points raised for each. The use of studies is excellent, which each being useful for the progression of the analysis and each one providing empirical evidence for the discussion. Overall this is a very strong essay.

Response to question

This is a very good essay, and primarily so because it breaks free of the typical prescriptive evaluation format most psychology essay questions restrict the candidate's to. Prescriptive psychology essays are not likely to be penalised, but a response such as the one above is likely to allow the examiner to retain more interest due to it's more fluid writing style. The candidate demonstrates a clear ability to outline and evaluate (perhaps doing quite a bit more than a simple outline for the biological treatments of schizophrenia) two different treatments for a psychotic disorder, and gives the impression of an expert due to their appropriate and accurate usage of highly complex psychological terminology. There is a consistent focus and the essay reads well, with all the information being easy to take in as a result of the good structure.

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