Paper 2 : Clinical Psychology – Content (AJW)



Describing CBT as a treatment for schizophrenia (AO1)Key PointKey Word/PhrasePeople with schizophrenia often lack necessary coping skills to manage their symptoms leaving them vulnerable to stress, which can trigger relapse; CBT can therefore be used to identify stressful situations and regulate the emotions associated with stress could help to prevent relapseCBT sessions will typically be tailored to the individual’s needs and therefore the length and number of sessions is vary widely; initial session will be spent establishing the “therapeutic alliance” as the trust between therapist and client is essential to the success of the therapy; the therapist will discuss the rationale of the therapy and help the person to identify and agree?on?treatment goalsThe therapist and client may structure the day into blocks which can then be reviewed in therapy using the ABC model to identify stressors or activating events and emotional consequences; next the therapist can help the person talk though the unhelpful beliefs associated with these events and emotions; using a “stress thermometer” can help the person to keep a daily record of their stress levels throughout the day CBT can also be help by training the person with schizophrenia to become more self-aware and recognise situations and prodromal symptoms which may precede decompensation, allowing them to initiate adaptive coping strategies such as stress management strategies (e.g. meditation) thus reducing the probability of relapse. CBT can also be used to help combat hallucination and delusions through verbally challenging the perceived reality and encouraging the person to test their hypotheses by collecting evidence from behavioural experiments for example. This evidence can then be discussed and used to debunk erroneous beliefs. When behavioural experiments in the real world may not be advisable for one reason or another, role play with therapist may be used Part of the CBT will also be to help educate the person with schizophrenia about their condition and their vulnerability to stress and also to build their sense of self, that is to help them to recognise that they are more than a person with a diagnosis of schizophrenia, in an effort to destigmatise their experience.The person’s self- concept and esteem may be improved by exploring?previous interests?and expanding the range of activities?that the person is involved with although this must be done appropriately as increased social interaction can be stressful and the person may need regular rest days with lower levels of stimulation ................
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