Schizophrenia sychlotron org Psychological treatments Treating schizophrenia Nondrugbased

Schizophrenia sychlotron. org. Psychological treatments

Treating schizophrenia Non-drug-based therapies l l Behavioural Psychodynamic Cognitive-behavioural Family therapy sychlotron. org. l

Behavioural therapies Reinforcing coherent/non-delusional speech l l l 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 sychlotron. org. l

Behavioural therapies Token economies l l 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 sychlotron. org. l

Psychodynamic therapies l Traditional psychoanalysis not likely to be effective Rosen (1946) suggested ‘direct analysis’ involving: l l l Brutal confrontation of patient’s problems Regression to childhood Therapist becomes a substitute parent/nurturer sychlotron. org. l

Psychodynamic therapies l Success claimed by Rosen and others Drake & Sederer (1986) suggest some therapies actually harmful esp. when they involve: l l A close relationship Regression High levels of emotionality These lead to longer hospitalisation & worsening of symptoms sychlotron. org. l

Cognitive therapies CBT strategies to challenge & help modify delusory beliefs l l 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 sychlotron. org. l

Cognitive therapies Normalising strategies where patient is taught to understand the nature of schiz. symptoms l l l 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) sychlotron. org. l

Family therapies Aimed at reducing ‘expressed emotion’ in the family environment through: l l reducing negative interactions Increasing understanding of schiz. symptoms Tackling feelings of guilt & anxiety Hoped to prevent relapse in patients following release sychlotron. org. l

Family therapy Some success: l l l 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 sychlotron. org. l