Shamima Although the use of antipsychotic drugs is crucial in treating schizophrenia. Additional treatment is usually required the two main type of therapies used are Cognitive behavioural therapy (CBT) and Psychoanalysis. The basic assumption behind CBT is people have distorted beliefs that influence their behaviour is maladaptive ways. For example a schizophrenic may believe their behaviour is being controlled by someone or something else. Delusions are a result from faulty interpretations of events. So cbt is used to identify and correct these. During cbt patients are encouraged to trace back the origins of their symptoms to get an idea of how symptoms may have developed. Patients are also encouraged to evaluate their delusions and hallucinations to test validity. Schizophrenics maladaptive responses to their life problems may be a result of distorted thinking. During cbt therapist allows patient to develop their own alternatives to these maladaptive beliefs. Outcome studies measure how well a patient does after treatment compared with the accepted form of treatment. Outcome studies of cbt suggest patients who receive cbt experience fewer hallucinations and delusions and recover functioning to greater extent than those receiving antipsychotic medication. Research has shown cbt improves symptoms for patients with schizophrenia. For example
Gould et al found all 7 studies in a meta analysis reported a decrease in positive symptoms after treatment using cbt. This therefore supports the psychological therapy cbt as it shows to have worked on a variety of patients picked out of the studies so proves the validity of the therapy. However a meta analysis was used and a general trend was found between all 7 a decrease of symptoms but this may not be because the therapy is working but may be a bias as researcher could have just picked out 7 specific studies which show a decrease in symptoms and not including those which don’t. This therefore can lead to biased set of data as it has been influenced by the researcher. This then reduces the reliability of the therapy as we do not know if the therapy is the cause of the improvement or any other confounding factors so we cannot be entirely sure as further comprehensive research will be required. Most studies of the effectiveness of cbt have been conducted with patients treated at the same time with antipsychotic drugs. So it is difficult to assess effectiveness of cbt independently. As we don’t know if the antipsychotic medication or cbt are causing the changes in condition so cause and effect is hard to establish with two different types of treatments being co occurred together. This affects the effectiveness of cbt as we cannot properly measure if it effective or not. Not everyone with sz will benefit from cbt as Kingdon and Kirshen found many patients deemed not suitable for cbt because psychiatrists believed they would not engage with therapy. And older patients deemed less suitable than young. This therefore shows that cbt may not be suitable for everyone and other forms of treatment may be more effective as everyone is different and individual differences play a role. This can help give psychologist a
way to help create and identify a criteria for each person in means which treatment would be best this would save time and money for patients. However this study was only conducted in
UK so can be criticised for being ethnocentric as the results may not represent everyone especially from different countries it may not be similar so therefore we cannot generalise and apply to this to all settings and people. More supporting evidence was found by Dury found benefits in terms of reduction of positive symptoms of 2550% reduction of recovery for patients with combined cbt and antipsychotic.
This supports cbt as it shows recovery improved when cbt and antipsychotic medication was used.
Therefore, this implies that CBT is a
