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CBT - Coggle Diagram
CBT
Evaluation
Evidence suggests that CBT plus antipsychotics is effective in treating SZ and more effective that drugs or CBT alone, supporting the case for combined treatments
For CBT to be effective training of CBT practitioners is essential as successful treatment is dependent upon empathy, respect, unconditional positive regard and honesty between patient and practitioner. This was supported by Rathod as he found that non afro caribbean therapists had less success using CBT with afro caribbean patients than white patients as empathy between clinicians and patients is harder to establish
It is not suitable for all patients, especially those too disorientated, agitated or paranoid to form trusting alliances with practitioners. It may be more suitable for those refusing drug treatments, though such patients are often so highly disturbed it is difficult to effectively undertake CBT
Fewer side effects than antipsychotic drugs but it is more expensive. This is a key factor at a time of reduced health care budgets
Trower - CBT did not actually reduce the intensity of hallucinations but made them seem less of a threat by persuading sufferers that they outranked the voices in their heads. This suggests that rather than treating the symptoms of SZ CBT teaches patients strategies for dealing with them
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Rational emotive behaviour therapy is also used to teach sufferers that emotional instability is a common feature of schizophrenia that they must live with.
Patients use muscle relaxation techniques to detect gradual anger build ups and then apply relaxation skills to control emotions
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Beliefs, expectations and cognitive assessments of self and the environment affect how individuals perceive themselves and others, how problems are approached and how successful people are in coping and reaching goals
CBT helps people with SZ change maladaptive thinking and distorted perceptions seen as underpinning the disorder in order to modify hallucinations and delusional beliefs
Antipsychotics are usually given first to reduce psychotic thought processes so that CBT is effective
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Drawings are often used to display links between sufferers thoughts, actions and emotions. Understanding where symptoms originate from can reduce anxiety levels
One CBT approach is personal therapy, involving detailed evaluation of problems and experiences, their triggers and consequences, and strategies being used to cope
PT is also used to tackle problems faced by schizophrenics discharged from hospital, taking place in small groups or as one to one therapy
Patients are taught to recognise the small signs of relapse, which can build up to produce cognitive distortions and unsuitable social behaviour
Tarrier - Reviewed 20 controlled trials of CBT using 739 patients, finding reduced symptoms, especially positive ones, lower relapse rates and a speedier recovery rate of ill patients. These were short term benefits though so follow ups would be needed
McGorry - found after 6 months of treatment 36% of people with a high risk of first onset SZ who received supportive psychotherapy had developed SZ, compared with only 10% who received drugs and CBT