Psychological Treatments of Schizophrenia

AO1 - Cognitive Behavioural Therapy

 Cognitive Behavioural Therapy can help individuals suffering

from Schizophrenia to understand that there are other
explanations for the symptoms they experience. It can also
help the patient to normalise their experience of the disorder.

 CBT may focus on the disorder itself, to help reduce the

anxiety of the patient. It is thought to be appropriate for
patients who are capable of gaining reasonable insight into
their problems.

 CBT is based on the idea of faulty cognitive processes and

thought patterns, so the aim of the treatment is to alter these
faulty thoughts and inappropriate beliefs.

 The process of CBT in the treatment of Schizophrenia is as

follows:

1. Positive symptoms (such as hallucinations and delusions)

are addressed in a process called cognitive challenge.

2. Patient is taught to regard their responses to these positive

symptoms as hypotheses rather than reality – this is
known as belief modification.

3. The patient then learns to challenge their original negative

interpretations.

AO2 – Cognitive Behavioural Therapy

 A strength involving the appropriateness of CBT is that it is a
collaborative therapy which involves the active co-operation
of patients. This is a strength because it means that it is more
ethical and appropriate than drug therapy as the patient is
not a passive recipient of treatment.

 A strength involving the effectiveness of CBT is that there is

research evidence to support it. For example, Turkington et
al (1998), found that CBT was effective in treating the
positive and negative symptoms of Schizophrenia, and that it
could be delivered effectively in brief intervention
programmes by community nurses. Also, Jones et al (2000)
carried out a meta-analysis of the trials of belief modification
and found that it reduced the frequency and intensity of
hallucinations, but was less effective in reducing delusions.

 Kopelowicz and Liberman (1998) reviewed the overall

benefits of CBT and found that it moderately improved
symptoms in 50-60% of patients, but only when used in
conjunction with drug therapy. Relapse rates were moderate
and the treatment was seen to be fairly expensive.

 Drury et al (2000) reported on a study in which belief

modification was used as part of the process. Immediate and
short term gains looked promising and effective, however
after a 5 year follow up, the treatment group had no
advantage over the control group. This therefore questions
the effectiveness of using CBT as a treatment of Schizophrenia
as there seems to be no long term outcome or success.