treatments for schizophrenia

what are the 7 standards which the HCPC sets out for clinical practitioners

character, health, standards of proficiency, standards of conduct, performance and ethics, standards for continuing personal development, standards of education and training, standards for prescribing

how is the character of clinical practitioners -

registrants have to provide credible character references from people who’ve known them for at least 3 years to give an idea of the character traits which makes them suitable for the role

how is the health of clinical practitioners -

they must provide information every 2 weeks when they re-register about their general health and are required to provide information on any health issues that are likely to affect their ability to practise safely

how are the standards of proficiency of a clinical practitioners -

set of specific expectations for the ability to practise effectively like professional autonomy, accountability, formulation and delivery of plans and strategies for meeting health and social care needs

what are standards of conduct, performance and ethics that a clinical practitioner -

a list of 14 guidelines that practitioners must adhere to like maintaining confidentiality in work with service users and only acting within the limits of their own knowledge of skills

what are standards for continuing personal development for clinical practitioners

they are expected to take part in and document regular training to develop their own practice like training events, evidence of how they’ve changed their practice and evaluation of the effectiveness of these changes by keeping up to date with current trends

what are standards of education and training for clinical practitioners

there are minimal levels of qualifications specified before people can register like some practices require a doctorate degree and those registrants need to be able to provide evidence of at least a masters degree

what are standards for prescribing for clinical practitioners

there are set out safe practice for prescribing medication by health and care professionals which includes the required knowledge and training to be able to prescribe within professional practice

what were the first anti-psychotic drugs used

phenothiazines

how do phenothiazines work

by blocking the receptors on the site for dopamine which means that the effects of dopamine aren’t picked up by the brain

what are the side effects of phenothiazines

shaking muscle tremors and jerky movements

what other drugs are now used

clozapine, olanzapine and risperidone

how does clozapine work

by blocking serotonin receptors

what are these new drugs known as and what are the side effects

atypical - focus on dopamine and other neurotransmitters

side effects are weight gain and tardive dyskinesia

what are strengths of drug treatment for schizophrenia (5)

• shown to be effective in reducing symptoms

• reduces symptoms more quickly

• useful as it can make patients more available to to psychological therapies

• allows patients to live relatively normal lives

• it is an appropriate treatment as schizophrenia has a more genetic and biological basis than any other mental disorder

what did zhaos meta analysis find

17/18 antipsychotics had significantly lower relapse rates

what are limitations of drug treatment for schizophrenia (7/10)

• reductionist

• effects are palliative rather than curative

• relapse can still occur as they can only provide short term alleviation of symptoms

• there are ethical issues

  • side effects

  • people with very serious conditions may be unable to give informed consent

  • can lead to addiction and dependency

• problems with compliance because of side effects people may be reluctant

• some patients are resistant to drugs

• most common drugs aren’t effective in treating negative symptoms

what did patel find

45% of people with schizophrenia experience partial or inadequate improvement using FGAs

what are does palliative mean

drug therapy supresses symptoms without addressing the underlying causal process so patients have to take drugs for several years

how does relapse occur when undergoing drug treatment

when the drugs aren’t taken

what does the cognitive model of abnormality assume

that mental disorders are created by errors in thinking so behavioural changes will result from changes in cognitive processes

what does CBT assume

that patients have irrational thoughts and beliefs about themselves and the world that are typically negative, self defeating and contribute to the development and maintenance of mental disorders

how do therapists use CBT

to challenge these irrational thoughts and show they are wrong so they can eliminate them

how are thoughts changed (3)

• by focusing on present symptoms

• looking at how the patient thinks about how an event has affected a person

• challenge negative thoughts and change them to more realistic, positive thoughts

what is the aim of CBT

to reduce the stress felt by the patient and allow them to help manage and understand their symptoms

how many CBT sessions do most people need

between 8-20

what are the three techniques CBT involves

belief modification, focusing and reattribution, and normalising the experiences of the person with schizophrenia

what is involved in belief modification

delusional thinking is challenged directly

what is involved in focusing and reattribution (3)

• attributes of the voices of auditory hallucinations and the content are focused on

• patient focuses on what they think about the voices

• therapist shows the voices are self-generated

what is involved in normalising the experiences of the person with schizophrenia

psychotic symptoms are looked at rationally and normally to reduce the fear and distress related to them

what are strengths of CBT as a treatment for CBT (3)

• most ethical

• strategies learned can be easily incorporated into a patients life

• effective in treating people who haven’t responded well to drug treatment

• there’s research which shows it is effective and useful

how is CBT the most ethical treatment type (3)

• empowers patients as they are educated on self help strategies

• patient has more control over the process

• can use the strategies on their own without the presence of a therapist

what did sensky find

CBT was more effective in reducing both positive and negative symptoms of schizophrenia

what are limitations of CBT as a treatment for schizophrenia (3)

• reductionist

• effectiveness may be limited

• effectiveness is hard to judge - difference may be because of the control treatment is inadequate and not always given by experts

what did mckenna and kingdon find

CBT was only superior to a control non-biological treatment for 2/9 studies