CBT (Psychological Treatment)

What does cognitive behavioural therapy assume?

That schizophrenia is the result of dysfunctional thought processes. Eg faulty cognitions such as delusions are identified with CBT and ultimately changed

What is the therapists role in CBT?

The therapists role is to challenge irrational beliefs, this could be by logically disputing the reality of the delusions and helping to develop alternatives

Ellis’s ABC(DE) model

Used to understand the source of the faulty cognition, and provide a process to cognitively restructure irrational beliefs (delusions)

• A - Activating event (drug treatment causes side effects)

• B - Beliefs (hospital staff are trying to kill them)

• C - Consequences (refusing treatment)

• D - Disputing irrational beliefs logically (the staff have no reason to kill them)

• E - Restructured belief causes effect (the drugs are necessary)

What is reality testing?

A process in which the patient can demonstrate for themselves that their irrational thoughts (hallucinations and delusions) are not real (symptom targeting). Such as if the patient believes they can see into the future, then the clinician may ask them to predict cards drawn from a deck

AO3 - Biological treatments may be better

Some patients, due to severity of symptoms or personality may not be able to cope with the vigorous confrontation of beliefs that CBT requires. In this case anti psychotics medication can be used first to reduce the severity of the symptoms

AO3 - Time consuming

Ending treatment early is common due to the length of treatment, symptoms may become severe in this time. CBT requires engagement, negative symptoms can lead to an unwillingness to take part, or positive symptoms leading to the distrust of the process

AO3 - Side effects vs cost

CBT does not produce the side effects of drug therapies making it a preferred treatment plan for many patients. However the significant cost of working with a trained therapist over multiple session mean drug therapy is more common