0.10 Psychological treatments - CBT

what is CBT based on

the theories of Beck and Ellis

suggest sz is caused by faulty thinking and irrational beliefs

what is the aim of CBT

identify and challenge irrational thoughts

what does the therapist do

create trusting environment

helps the patient consider realistic alternatives

how many sessions do patients usually have

between 5 and 20 sessions for roughly an hour

can either be as a group or individual basis

what are the typical stages of CBT for sz

• assessment

• engagement

• the ABC model

• normalisation

• critical collaborative analysis

• developing alternative explanations

what is the assessment stage

allows them to explore their own thoughts about their experiences

therapist actively listens + makes them comfortable

asks how symptoms started, when they developed, any goals of the patient

building trusting relationship

what is the engagement stage

guided discovery

can use drawings

therapist might not have answers but can help explain

what us the ABC model stage

activating event, belief, consequence

identify - activating belief

explore - belief

recognise - consequence

patient rates on scale of 1-10 the intensity of distress

therapist encourages them to reality test their belief

what is the normalisation stage

therapist teaches them to understand the nature of schizophrenic symptoms

feel less alienated

helps recovery

‘some people i see say voices in their head get louder when they’re stressed, like other’s may get headaches… does you experience that?

what is critical collaborative analysis

uses gentle questioning to help understand illogical delusions + conclusions

needs trust, empathy and no judgement

used as homework

what is developing alternative explanations

patient develops other explanations for previously unhealthy assumptions

what research supports CBT as treatment

• Pontillo et al

• Jauhar

what did Pontillo et al find

CBT showed reduction in frequency and severity of auditory hallucinations

what did Jauhar find

meta - analysis of 34 studies

showed CBT had a small but significant effect on positive and negative symptoms