Transcript Schizophrenia: Treatments and Therapies

Schizophrenia: Treatments
and Therapies
Drug, Humanistic, Behaviour and
Cognitive Therapies
Introduction
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Psychological problems are both
distressing and disruptive for the
individual sufferer.
So, there is an immediate need to
alleviate these conditions through
appropriate forms of therapy and/or
treatment.
Treatment v Therapy
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Definition of Treatment: the medical or surgical management
and care of a patient.
Examples: Chemotherapy, prescription of medicines to
cure/treat symptoms of a disease or disorder.
Definition of Therapy: In the broadest sense, Therapy is a term
that can be applied to any form of treatment for any illness or
disorder.
For example, antacid is a form of therapy for heartburn,
rehabilitation is a form of therapy for addiction, and exercise is a
form of therapy for obesity.
As it relates to mental health and mental disorders, therapy is
usually a general term used to reference the sessions held
between a therapist and a patient. E.g. Cognitive Behavioural
Therapy (CBT), Family Therapy, etc.
Treatments and Therapies for
Schizophrenia
Schizophrenia can be treated via the
following ways:1.
Drug Treatment (medicinal)
2.
Humanistic Therapy (especially ClientCentred Therapy)
3.
Behaviour Therapy (Family Therapy)
4.
Cognitive Therapy (CBT)
1. Drug Treatment
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Drug therapies for schizophrenia have radically revolutionised the way
schizophrenia sufferers are treated and cared for.
The use of effective antipsychotic drugs became common in the 1960s
and 1970s, seeing a drastic reduction in the number of schizophrenic
sufferers who need long-term institutionalised care.
It has led to such sufferers reaching a level of normal functioning that
permits care to take place in the community.
Indeed, Lamb (1984) found that prior to the 1980s, it was estimated
that 2 of 3 patients would spend their lives in a psychiatric institution;
the average length of stay is down to about 2 months, post 1980s.
Drug Treatment Contd…
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Antipsychotics, e.g. chloropromazine and haloperidol, block dopamine
receptors and help to reduce the high levels of dopamine in the brains
of schizophrenics.
These drugs not only reduce the major positive symptoms, e.g.
thought disorder and hallucinations, but can also reduce major
negative symptoms, e.g. social withdrawal, too.
The NHS use recommend the use of both typical (those developed in
the 1950s) and atypical antipsychotics (those developed during the
1990s) to patients till episodes of acute schizophrenia have passed.
The NHS also recommend their long-term use to prevent further acute
schizophrenic episodes occurring.
The NHS have reported the following side
effects which schizophrenic patients have had:-
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Typical
Antipsychotics
drowsiness,
shaking,
trembling,
muscle twitches, and
spasms.
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Typical and Atypical
Antipsychotics
weight gain,
blurred vision,
constipation,
lack of sex drive, and
dry mouth.
2. Humanistic Therapy
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Throughout the 20th century, many psychotherapists felt that
psychological therapy was focussing to much on structures, like
personality; losing sight of how the sufferers felt.
Consequently, a number of Humanistic therapies developed: ClientCentred Therapy and Gestalt Therapy
Key features of humanistic therapies include:They were holistic therapies- considering the patient as a whole,
and not just their particular psychopathological symptoms
Therapy should help enable patients to make their own decisions
and solve their problems, rather than imposing structured
treatments or ways of thinking on to them
Focus on the therapist-client relationship should be based on
genuine care and empathy, rather than the limited, constrained type
which professional specialists maintain.
Emotional awareness in patients need to be developed, before
patients can face and resolve their life problems, as it helps alleviate
psychological distress.
Client-Centred Therapy
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Carl Rogers (1902-87), a psychologist who
developed client-centred therapy during the
1940s and 1950s
It is also known as Person-Centred Therapy
(PCT) and Rogerian Psychotherapy
Crucial to this therapy is the creation of a
therapeutic climate that allows the client to
progress from a state of rigid self-perception
to one which encourages the client to become
independent, self-directed and who can
pursue self-growth.
Client-Centred Therapy
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There are three core elements of practice in clientcentred therapy:
Empathy: being able to put yourself in the client’s
shoes is the central important feature of any
therapist-client relationship, as it helps guide the
client to resolve their own life problems
Unconditional Positive Regard: The therapist
demonstrates that they value the client for who
they are and refrain from judging them
Congruence: Sharing a genuine, consistent rapport
with the client, where therapists primarily act as an
understanding listener who assists the client by
offering advise only when asked.
3. Behaviour Therapy
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During the 1940s and 1950s, dissatisfaction
towards the unscientific approaches towards
psychopathology was growing
Psychologists looked towards experimental
psychology for objective knowledge that
might be used to inform treatment and
therapy
Conditioning the body of knowledge which
psychologists gradually resorted to and this
gave rise to the development of Behaviour
Therapies
Types of Behaviour Therapy
Classical Conditioning
1.
Flooding
2.
Counter-conditioning
3.
Systematic Desensitization
These are used to treat phobias
and anxiety-based
disorders.
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Operant Conditioning
Functional Analysis (treats
challenging behaviour)
Token Economy Schemes,
including Group/Family
Therapy
Response Shaping (treats
severe learning difficulties)
Self-Control (treats
addictive behaviours)
What is Group Therapy?
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Therapy can be taken in groups as well as on
a one-to-one basis
Group therapies are found to be useful to
treat individuals suffering from problems by
sharing their ordeal with one another and
having a facilitator guiding them towards
finding ways of resolving their problems.
Examples of Group therapies: Self-Help
groups, Alcoholics Anonymous, Gamblers
Anonymous and Family Therapy.
Family Therapy
Dallos and Draper (2002) have found that Family Therapy is becoming increasingly
helpful as a means of dealing with psychopathology that may result from the
relationship dynamics within the family.
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According to the NHS, who use family therapy to treat schizophrenic sufferers:
Many people with schizophrenia rely on family members for their care and support.
While most family members are happy to help, the stress of caring for somebody with
schizophrenia can place a strain on any family.
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Family therapy is a way of helping both the sufferer and their family to cope better
with the condition.
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Family therapy involves a series of informal meetings that take place over a period of
six months.
Meetings may include:
1.
discussing information about schizophrenia,
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exploring ways of supporting somebody with schizophrenia, and
3.
deciding how to solve practical problems that can be caused by the symptoms of
schizophrenia.
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Often the therapist applies the systems theory, which attempts to understand the
family as a social system, as a treatment to understanding the complex relationships
and alliances that exist between family members. The next step would be remould
these relationships into those expected in a well-functioning family.
Source: http://www.nhs.uk/Conditions/Schizophrenia/Pages/Treatment.aspx
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Family Therapy Videos
Video Clip on Structured Family
Systems:
http://www.youtube.com/watch?v=91wT
CgPa_xw
 Video Clip from the BBC 2 Series “The
British Family:
http://www.bbc.co.uk/programmes/b00q0
8ft
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3.Cognitive Therapy
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Over the latter part of the 20th Century,
one of the most impressive
developments in our understanding of
psychopathology has been our evolving
insight into cognitive factors that play
important roles in causing and
maintaining psychopathology.
Key features of Cognitive
Therapy include:
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Cognitive therapy is all about learning how
our our thoughts create our moods.
In CT we discover that we all have inherent
tendencies to certain negative thoughts that
evoke unhappiness and disturbance especially in response to particular trigger
situations.
Once we accept that fact, we can learn to
spot these negative thoughts as they arise,
and then challenge and re-think them.
Who pioneered Cognitive
Therapy?
Albert Ellis
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Developed one of the first
cognitive therapies to
address how people construe
themselves, their life and the
world (circa 1962)
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He came up with RationalEmotive Therapy (RET)
which challenges irrational
beliefs and persuades
patients to set more
attainable life goals.
Aaron Beck
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a medical doctor, psychiatrist
and psychoanalyst who
came to believe that he was
not getting enough
improvement in his patients
through analysis. (circa
1967)
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He realised that often what
was holding back patients
were negative thoughts such
as: 'I'll be hopeless at that',
or 'I'm unlovable', or 'I'm
stupid'.
Contemporary Cognitive
Behaviour Therapy (CBT)
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CBT came out from these earlier forms of Cognitive
Therapies.
CBT is an intervention for changing both thoughts
and behaviour, representing an umbrella term for
many different therapies that share the common aim
of changing both cognitions and behaviour.
CBT is generally perceived to be an evidence-based,
cost-effective form of treatment that can be
successfully applied to a broad range of
psychopathologies, including Schizophrenia and
Depression.
Characteristics of a CBT
Intervention
A CBT intervention usually possesses the following characteristics:1.
The client is encouraged to keep a diary noting the occurrence of
significant events, associated feelings, moods and thoughts in order
to demonstrate how these might be interlinked.
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With the help of the therapist, the client is urged to identify and
challenge irrational, dysfunctional, or biased thoughts/assumptions
3.
Clients are given homework in the form of ‘behavioural experiments’
to test whether their thoughts and assumptions are accurate and
rational.
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Clients are trained in new ways of thinking, behaving and reacting in
situations that may evoke their psychopathology.
Tip:- You may want to visit this link to know more about how CBT is
applied to clients with severe disorders and as well on those who
suffer from negative thinking and stress.
http://www.netdoctor.co.uk/diseases/depression/cognitivetherapy_000439.
htm
Summary Chart
Approaches to Psychology
Biological
Drug Therapy;
Chemotherapy
Psychodynamic
Psychoanalysis;
Humanistic
Therapy
Classical Conditioning
Client-Centred Therapy
Person Centred Therapy
Behavioural
Cognitive
Operant
Conditioning
RET
And
CBT
Group Therapy
Family Therapy