CBTp used as a treatment. Identifies faulty interpretations of reality - which result in delusions. Recommended 16 sessions

Therpist discusses the person's current symprtoms and their origins. Then set realistic therapeutic goals.

 Therapist empathises with the person's distress

 Challenge person's beliefs - changing the prson's beliefs/behaviour.

PLACING PSYCHOTIC EXPERIENCES ON A CONTINUUM WITH NORMAL EXPERIENCES. 

 empathetic and non-judgemental questioning - helps person understand their false beliefs. 

 Enables healthier explanations for behaviour

NICE'S REVIEW SHOWED CBTP IS MORE EFFECTIVE IN REDUCING SYMPTOM SEVERIETY THAN MEDICATION. BUT IT IS USUALLY USED WITH MEDICATION.

FAILED TO ALLOCATE PPS RANDOMLY TO TREATMENT CONDITIONS. FAILS TO MASK CONDITIONS FOR THE ASSESSORS - BIAS

 Jauhar - found CBTp has small effect on reducing hallucinations and delusions - although this changes with 'blind' judges

ADDINGTON SAYS CBTP IS INAPPROPRIATE IN THE INITIAL PHASE OF SCHIZOPHRENIA. MORE APPROPRIATE AFTER STABALISATIOJN OF SUMPTOMS WITH MEDICATION. 

 UK - available to 10% of people. When available, many refuse it or fail to attend

RANGE OF INTERVENTIONS SURROUNDING FAMILY AND FRIENDS. IMPROVES ENVIRONMENT FOR SCHIZOPHRENIC - DECREASE RELAPSE RATE

 3-12 months, ten sessions, used with medication, reduces EE & stress

 Psychoeducation. Knowledge helps families support the schizophrenic

 Reduces emotional climate within family. Schizophrenic is encouraged to talk about their family and what is helpful

MAINTAINING SOME DEGREE OF SEPERATION. IMPROVES HOUSEHOLD RELATIONSHIPS - OPENLY DISCUSS PROBLEMS. 

 Pharoah et al. FT effects mental state but also on medication compliance. Improvement due to medication rather than therapy

 FT adds cost but causes a reduction in rehospitalisation due to lower relapse rates

Pharoah, Meta-analysis 53 studies, many failed to randomly allocate pps. 20% failed to use 'blind' observers

 Garet et al. - FT and having carer without FT both had lower relapse rates

 Lobban - 60% of studies had at least one positive impact for relatives but the studies were methodologically poor

Behavioural therapy - uses operant conditioning - psitive reifnorcement. Decreases negative symptoms.

TOKEN IS PAIRED WITH SOMETHING OF VALUE. TOKEN=SECONDARY REINFORCER (SR) TOKEN ACQUIRES VALUE OF THE PRIMARY REINFORCER (PR)

SET TARGET BEHAVIOURS AND USE TOKENS IMMEDIATELY AFTER THEY'RE PERFORMED - BEHAVIOUR IS THEN LEARNED.

TOKENS ARE EXCHANGED FOR PR (GENERALISED REINFORCERS). THE SMALLER THE TIME INTERVAL, THE MORE EFFECTIVE TE IS

 Dickerson, 13 studies. 11 reported beneficial effects. TE increases the target behaviour of patient

TEs INVOLVE SCHIZOPHRENICS IN AN INSTITUTION - POSSIBLE THAT INCREASED ATTENTION IS CAUSING BEHAVIOURAL IMPROVEMENTS

 Clinicians exercise control over valuable reinforces such as food - patient's basic rights are violated

SCHIZOPHRENICS RECEIVE 24-HOUR CARE SND ARE REWARDED IMMEDIATELY. PATIENTS LIVING IN COMMUNITY ARE ONLY SEEN A FEW HOURS A DAY

TEs ARE UNCOMMON DUE TO ABSENCE OF SUCH TRIALS. LACK OF EVIDENCE - NOT AS POPULAR