CBT

Aims to identify and challenge irrational thoughts. Involves face to face sessions, homework tasks, requires motivation and effort and used in treating depression.

Works on the assumption that sz is caused by cognitive dysfunctions such as meta representation (not knowing your own thoughts are yours) difficulties and issues with central control

Techniques involve:

• mood diary

• Technique diary

• Diary to use against irrational thoughts

Behavioral experiments - gather evidence that helps to recognize there is a need for patients to change the way they think and behave.

The goal is to get the patients to recognize that reality is not what they initially expected and therefore demonstrating there are cognitive issue they need to overcome.

E.g. delusions of persecution - get them to go out and experience no one harming them and then reflect on it and talk about it.

How does CBT differ between Schitz and depression?

Sz

• Challenge irrational thoughts, e.g. delusions of persecution

• Use behavioral experiments to challenge distorted reality e.g. delusions of grandeur

Depression

• challenge irrational thoughts, such as negative views of the self, world and future

• Use mood and routine diaries to increase engagement with others and reflect on what causes low/good mood

AO3

Ethics

Conflicting research

Limits how reliable and valid the research is

Not always a cure

Instead improves the quality of the patients life. Sz appears to be largely biological and therefore will require biological treatments. CBT may reduce posative and negative symptoms but will only ever manage the symptoms and not cure them.

Issues and debates

Nature vs nurture

Implications - Improve peoples quality of life, means they can actually work or generally have better quality of life.

Reductionist - Taking Sz which is a really complex disorder and believing you can cure this through treating irrational thoughts and believing it’s purely based in cognition. This is not fully looking at Sz and therefore not treating it properly.

Family therapy

Done to improve the communication between the family and the patient. Holistic as cares about the family as well.

Family dysfunction is about dysfunctional communication.

Double bind theory - conflicting physical and verbal communications, causing confusing communications for the child

High expressed emotion - tension, arguments and hostility within the family. This could also involve secrecy.

Low expressed emotion - calm, respectful, give you privacy and have low hostility within the family.

Expressed emotion is measured through self report methods.

Family dysfunction is reductionist as it reduces Sz down to communication issues.

Involves:

• Weekly meetings with therapist

• Multiple interviews to establish cause of family dysfunction that could be contributing to Sz

Aims:

• improved communication

• Improved education about condition

• Improved levels of expressed emotion at home - lower it

  • better use of language and body language

  • Avoiding or resolving arguments

  • Respecting each other

Reduce negativity and criticisms

AO3

Could be counter productive to have the family involved in therapy if they caused the issue in the first place.

Strength - lots of backing up evidence to support the theory. Anderson et al..

Only appropriate if the cause is family dysfunction, not if the cause is biological.

Issues and debates

Nature/nurture - all about nurture and environment, it ignores nature.

Reductionist - just focuses on family and not other causing factors