Schizophrenia
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Transcript Schizophrenia
Schizophrenia
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Psychological treatments
Treating schizophrenia
Non-drug-based therapies
Behavioural
Psychodynamic
Cognitive-behavioural
Family therapy
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Behavioural therapies
Reinforcing coherent/non-delusional speech
Some success e.g. Nydegger (1972) - apparent
reduction in hallucinations, delusions
May be that patients learn not to talk about
symptoms rather than symptoms actually reduced
Results do not generalise well to non-clinical
situations
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Behavioural therapies
Token economies
Early successes, esp. with negative symptoms
May be due to better organisation/more positive
staff behaviour, not reinforcement
Changes may not last
Ethical/human rights problems
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Psychodynamic therapies
Traditional psychoanalysis not likely to be
effective
Rosen (1946) suggested ‘direct analysis’
involving:
Brutal confrontation of patient’s problems
Regression to childhood
Therapist becomes a substitute parent/nurturer
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Psychodynamic therapies
Success claimed by Rosen and others
Drake & Sederer (1986) suggest some
therapies actually harmful esp. when they
involve:
A close relationship
Regression
High levels of emotionality
These lead to longer hospitalisation &
worsening of symptoms
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Cognitive therapies
CBT strategies to challenge & help modify
delusory beliefs
Identify delusions
Challenge evidence on which delusions are
based
Design ‘experiments’ to test reality of this
evidence
Chadwick & Lowe (1993) – significant
reductions in delusions in 10 out of 12
patients
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Cognitive therapies
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’
Helps 70% of patients although other 30%
may deteriorate (Kingdon & Turkington, 1996)
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Family therapies
Aimed at reducing ‘expressed emotion’ in the
family environment through:
reducing negative interactions
Increasing understanding of schiz. symptoms
Tackling feelings of guilt & anxiety
Hoped to prevent relapse in patients following
release
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Family therapy
Some success:
Lower relapse rates compared with individual
therapy (12% vs. 50%; Falloon et al, 1985)
As effective as social skills training (both 20%
relapse) but most effective when both combined
(<10% relapse rate; Hogarty et al, 1986)
Follow-up data suggest that relapse is
delayed, not prevented
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