Schizophrenia 5- CBT, family therapy and token economies

What is CBT used for in schizophrenia?

CBT is used to help patients identify and challenge irrational thoughts and beliefs linked to their symptoms, such as delusions and hallucinations.

What is the cognitive focus of CBT for schizophrenia?

CBT focuses on identifying faulty beliefs, cognitive distortions, and irrational interpretations of events that contribute to psychotic symptoms.

What is the behavioural focus of CBT for schizophrenia?

CBT encourages patients to test the reality of their beliefs and develop coping strategies to manage symptoms, such as voices.

How does CBT help with hallucinations?

CBT helps patients understand that hallucinations are not real and reduces the emotional distress caused by them rather than eliminating them.

What role does the therapist play in CBT for schizophrenia?

The therapist helps the patient challenge delusional beliefs, consider alternative explanations, and develop coping strategies.

When is CBT typically used for schizophrenia?

CBT is often used alongside drug therapy, especially when patients are stabilised on medication.

AO3: Evidence supporting CBT for schizophrenia

Research shows CBT can reduce symptom severity and distress, particularly positive symptoms, improving patient quality of life.

AO3: Effectiveness for treatment-resistant patients

CBT can be beneficial for patients who do not respond well to antipsychotic medication.

AO3: Ethical advantage of CBT

CBT has no harmful physical side effects, making it ethically preferable to drug therapy.

AO3: Limited effectiveness criticism

CBT is not effective for all patients, particularly those with severe symptoms or low insight.

AO3: Cost and availability issue

CBT is time-consuming, expensive, and requires trained therapists, limiting accessibility.

AO3: Symptom management criticism

CBT helps patients cope with symptoms rather than cure schizophrenia.

What is family therapy used for in schizophrenia?

Family therapy aims to reduce relapse by improving family communication and reducing stress within the family environment.

What is expressed emotion (EE)?

Expressed emotion refers to levels of criticism, hostility, and emotional over-involvement within a family.

Why is expressed emotion important in schizophrenia?

High levels of expressed emotion are associated with increased relapse rates in schizophrenia.

How does family therapy reduce expressed emotion?

Family therapy educates family members about schizophrenia, improves communication, and teaches coping strategies

What is a token economy?

A token economy is a behaviourist-based treatment for schizophrenia where patients receive tokens for desirable behaviours, which can be exchanged for rewards.

What type of therapy is a token economy?

It is a behavioural therapy based on the principles of operant conditioning.

Who developed the concept of the token economy?

The token economy is based on Skinner’s theory of operant conditioning.

What behaviours are targeted in a token economy?

Desirable behaviours such as self-care, social interaction, attending therapy sessions, and taking medication.

What are tokens in a token economy?

Tokens are secondary reinforcers given immediately after a desirable behaviour, which can later be exchanged for primary reinforcers.

What are primary reinforcers in a token economy?

Rewards such as food, drinks, privileges, or leisure activities.

How does positive reinforcement work in a token economy?

When a desirable behaviour is followed by a reward, the likelihood of that behaviour being repeated increases.

What symptoms is token economy most effective for?

Negative symptoms such as lack of motivation, poor self-care, and social withdrawal.

Where is token economy typically used?

In institutional settings such as hospitals or care homes, where behaviour can be closely monitored.

AO3: Evidence supporting token economy

McMonagle and Sultana (2000) found that token economies can improve social behaviour and self-care in patients with schizophrenia.

AO3: Practical advantage of token economy

Token economies are relatively easy to implement and do not require highly trained therapists.

AO3: Ethical issue with token economy

Critics argue it is manipulative and may exploit vulnerable patients by controlling their behaviour.

AO3: Temporary effects criticism

Improvements may not last once the token economy is removed, limiting long-term effectiveness.

AO3: Symptom vs cause criticism

Token economies manage behavioural symptoms but do not address the underlying causes of schizophrenia.

AO3: Limited effectiveness criticism

Token economies are mainly effective for negative symptoms and are less useful for treating positive symptoms like hallucinations and delusions.

AO3: Real-world application strength

Token economies help patients develop practical skills needed for independent living, improving quality of life.