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CBT - SZ METHOD OF MODIFICATION - Coggle Diagram
CBT - SZ METHOD OF MODIFICATION
CBT
It was thought that the principles of CBT could be applied to other psychotic disorders like schizophrenia
CBT is an official recommended treatment for schizophrenia that, according to the NICE clinical guidelines on schizophrenia, should be offered to all people with schizophrenia. However, it is still only available to less than 10% of patients in the UK with schizophrenia
CBT is used to help individuals who are suffering with schizophrenia to think about and organise their disorganised thoughts
They do role play exercises and homework to test out their faulty thinking and are helped to see the consequences of thinking differently
Schizophrenics are encouraged to reality test their hallucinations and delusions- question and ignore the voices to reduce the level of distress
ELLIS' ABC MODEL
Disorders begin with an activating event (A) e.g. failed exam, which leads to a belief (B) about why this happened
The belief can be rational or irrational
The belief leads to a consequence (C), rational beliefs produce adaptive consequences, irrational beliefs produce maladaptive consequences
BECKS NEGATIVE TRIAD
identified the negative triad of automatic thoughts linked to depression- negative views about:
Themselves
The world
The future
EVALUATION
EFFECTIVENESS
Kuipers et al (1997) 60 individuals with schizophrenia who had a positive and distressing symptom that was medication resistant were randomly allocated to either a CBT plus standard care condition or a standard care only condition
After 9 months of therapy, researchers found that there was a change in those who received CBT
CBT condition- 50% of participants were considered to have improved with only 1 becoming worse
Standard condition- 31% improved, 3 people became worse and 1 attempted suicide
SHORT TERM EFFECTIVENESS
Effectiveness of CBT is studied in short term programmes
Tarrier et al (2004)
studied individuals who either received CBT shortly after a diagnosis or received standard care
18 months later the CBT group had the same relapse rate as clients who had received standard care
ETHICAL ISSUES
LACK OF EQUAL ACCESS
Some psychiatrists may feel that CBT is not a viable option
This may be due to clients not believing their diagnosis is accurate or that the client may not engage in sessions or the individual is doing well on medication
Kingdon and Kirschen (2006) reported that of 142 individuals who had been diagnosed with schizophrenia, only 49% were referred to CBT
Psychiatric prejudice may be limiting the access to CBT in individuals
SOCIAL IMPLICATIONS
NOT OFFERED TO EVERYONE
There are significant variation in the amount of individuals offered CBT in the different Trusts
CBT offered in Trusts ranges between 67% to 14%, with an average of 50% of people reporting not being offered CBT
This is worrying when NICE recommends CBT
COST EFFECTIVE
Kuipers et al (1998) analysed the economic impact of offering CBT to individuals with schizophrenia in addition to antipsychotic medication
Cost involved in CBT would reduce the later cost of other services in the future