Psychological Treatments for Schizophrenia [AQA ALevel Psychology]

Summary

This video explores three psychological treatments for managing schizophrenia: Cognitive Behavioral Therapy (CBT), family therapy, and token economies. CBT focuses on challenging dysfunctional thoughts like delusions, with research showing its effectiveness in improving symptoms, though its lengthy process can be a challenge. Family therapy improves family dynamics to reduce relapse, with evidence supporting its effectiveness in preventing relapses, although it requires significant time and effort. Token economies use reinforcement to manage behavior, particularly in psychiatric settings, though ethical concerns arise around differential treatment and the manipulation of patients' behavior. Each treatment has strengths and limitations based on patient needs and context.

Takeaways

• 😀 CBT (Cognitive Behavioral Therapy) aims to address dysfunctional thought processes in schizophrenia by identifying and challenging irrational beliefs, such as delusions.
• 😀 The ABCDE framework in CBT helps to restructure faulty cognitions: Activating event (A), Belief (B), Consequence (C), Disputation (D), and Effect (E).
• 😀 Reality testing is a CBT technique where patients demonstrate the irrationality of their beliefs in a safe environment, such as predicting the outcome of a deck of cards.
• 😀 Research, like Senskey's study, shows that CBT can be effective, especially for patients who are resistant to drug treatment, and it may offer long-term benefits.
• 😀 A criticism of CBT is its long treatment duration, which can be challenging for patients due to the severity of symptoms, leading to disengagement.
• 😀 Family therapy focuses on improving family relationships, educating them about schizophrenia symptoms, and reducing stress and conflict, with the goal of preventing relapse.
• 😀 Psychoeducation in family therapy helps families understand unusual behaviors and fosters empathy and better communication with the patient.
• 😀 Left's study found that family therapy reduced relapse rates significantly, with only 8% relapsing after 9 months, compared to 50% for those receiving standard care.
• 😀 Family therapy has a potential drawback in its length, which can last up to a year, and some families may experience difficulties maintaining new communication patterns.
• 😀 Token economy is based on operant conditioning principles, where positive behaviors are reinforced with tokens, which can later be exchanged for rewards like treats or activities.
• 😀 Token economy helps manage behavior in psychiatric institutions, especially for patients with mild symptoms, but it does not address the core symptoms of schizophrenia.
• 😀 Ethical concerns in token economy include the unequal treatment of patients with severe symptoms, who may be excluded from rewards, leading to potential issues of fairness and dignity.

Q & A

What is the main assumption behind Cognitive Behavioral Therapy (CBT) for schizophrenia?

CBT assumes that disorders like schizophrenia arise from dysfunctional thought processes, and it focuses on identifying and changing faulty cognitions, such as delusions.

How does the therapist challenge a patient's delusions in CBT?

The therapist challenges the patient's delusions by using logic to dispute irrational beliefs, aiming to restructure the patient's cognition and encourage a more rational understanding of their situation.

What is the ABCDE framework used in CBT?

The ABCDE framework is a model used in CBT where 'A' represents the activating event, 'B' is the belief, 'C' is the consequence, 'D' is the dispute of the belief, and 'E' is the effect of the restructuring.

What is reality testing in CBT, and how is it used to treat schizophrenia?

Reality testing involves the patient demonstrating to themselves that their beliefs are irrational, often in a controlled environment. For example, a patient may use a deck of cards to test their belief of being psychic by predicting the card drawn.

What did Senskey's research suggest about the effectiveness of CBT for schizophrenia?

Senskey's research found that CBT was effective in improving both positive and negative symptoms of schizophrenia, even for patients resistant to drug treatment, with improvements continuing long-term after therapy.

What are some criticisms of CBT in treating schizophrenia?

Criticisms of CBT include its long duration, which may result in patients dropping out due to severe symptoms, and the difficulty some patients face in engaging with the process due to negative or positive symptoms interfering with motivation and awareness.

What is the goal of family therapy in the context of schizophrenia treatment?

Family therapy aims to improve relationships within the family of a person with schizophrenia, reduce stress and conflict, and prevent relapse by promoting understanding and communication, as well as improving coping strategies.

What are the key components of family therapy for schizophrenia?

Key components of family therapy include educating the family about schizophrenia, reducing conflict and expressed emotion, improving communication, managing carer stress, and enhancing problem-solving skills.

What did Left's research reveal about the effectiveness of family therapy for schizophrenia?

Left's research found that patients receiving family therapy had significantly lower relapse rates after 9 months and 2 years compared to those who received standard outpatient care, suggesting that family therapy is effective in reducing relapse.

How does token economy work as a treatment for schizophrenia?

Token economy uses operant conditioning principles, where patients earn tokens for positive behaviors, which can be exchanged for rewards. This approach aims to shape behaviors over time and is often used in psychiatric institutions to manage patients' behavior.

What are some ethical concerns associated with token economies in schizophrenia treatment?

Ethical concerns about token economies include the potential for unequal treatment of patients with varying severity of symptoms, as well as the use of operant conditioning to manipulate patients' behavior, which could be seen as degrading.

Why is token economy typically not used for patients with severe symptoms of schizophrenia?

Token economy is usually ineffective for patients with severe symptoms, as they may not be able or willing to engage with the process, and the treatment is better suited to patients with milder symptoms.

What is the primary limitation of token economies as a treatment for schizophrenia?

The primary limitation of token economies is that they do not directly address the core symptoms of schizophrenia, such as delusions or hallucinations, and instead focus on improving adaptive behaviors like motivation and self-care.