Discuss ONE psychological therapies for schizophrenia (4+8)

(4+8)
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One of these therapies is CBT, Cognitive Behavioural Therapy. The main assumption of this therapy is that patients have distorted beliefs that influence their behaviour in maladaptive ways. Delusions are thought to arise from faulty interpretations of events and CBT aims to correct these. In CBT, a patient is

encouraged to trace back the origin of their symptoms to see how they may have developed. They are also asked to assess the validity of their delusions and hallucinations, to try and make them see that these are irrational and not true. For instance, the therapist may ask the client to question how true the visual hallucination of a man behind them is if no one else can see it. Patients are also set behavioural assignments to help their treatment, and these may come in the form of practices such as breathing exercises to  alleviate the distress caused by the positive symptoms of the disorder. Therefore, CBT aims to work with the client to help alleviate distress caused by the symptoms, and to help their faulty cognitions which manifest in faulty beliefs.

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The effectiveness of CBT has been advocated by many studies. For instance, Gould et al (2001) carried out a meta-analysis of 7 studies and found that all of them reported a statistically significant decrease in the positive symptoms after treatment. Such findings illustrate that CBT has been proven to be effective in helping patients overcome their symptoms from the disorder. If these are alleviated, then the patient will experience less distress and thus have a better chance at returning to normal functioning, strengthening the argument for the effectiveness of CBT. Alongside this, Drury et al (1996) corroborates with Gould’s findings, as well as reporting a 25-50% reduction time in recovery when using CBT alongside antipsychotics. This thus adds more weight to the proposal that CBT is an effective therapy. If not only positive symptoms, but recovery time is reduced, there are extreme benefits to going through such therapy for the patient, allowing us to logically conclude that it would be a beneficial treatment. Yet, the findings of such studies have their limitations. For instance, drawing the debate out into the wider picture, there is the issue of how much of the effectiveness is down to CBT alone. Studies such as those above look at the effectiveness of CBT alongside the use of antipsychotic drugs, which raises questions as to whether biological alone or psychological alone is doing the most work. From these studies, there is no way to be certain, and this it can be argued that there is no one approach to curing the illness, and that a combination of both of these treatments is required.

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Even with this dilemma, there is the other issue of how appropriate such treatment is. Kingdon and Kirschen (2006) looked at 147 patients, and found that only a minute amount of them were suitable for CBT. The ones that were not were more likely to have greater severity in their illness, which highlights the important consideration that the appropriateness of CBT is entirely down the individuals level of functioning. If this is still relatively normal, they can go through CBT. However, if it is not, then CBT is arguably not an effective therapy for them as it involves engagement with it and this can be challenging for those with severe schizophrenia.