1. Starter…. Similarities Differences
Biological Explanation of Schizophrenia
Cognitive Explanation of Schizophrenia

2. Biological Explanation of Schizophrenia
Similarities
Differences
Biological Explanation of Schizophrenia
deemed deterministic as they provide complete reasons for the psychosis, however fail to consider free will as many would argue that there is a considerable amount of choice regarding behaviours and thoughts.
take into account the role of the family which is a vital aspect to consider when looking at the development of schizophrenia.
Both explanations explore family influence in order to discover the origin of the disorder and how it builds a foundation over the years until the illness triggers
highly scientific - OFR, what methods are used?
the biological approach is reductionist as it focuses fully on the bodily and natural causes, ignoring any environmental aspects they may contribute to the development of schizophrenia
biological explanation allows us to deal with schizophrenia as it has helped in the development of various treatments which have been proven highly successful in controlling the unbearable symptoms of schizophrenia
Explanation is quite generic but scientific – factual
Cognitive Explanation of Schizophrenia
is more credible and explores more than one factor that could effect the initiation of schizophrenia – cognitive processes and the environment and some elements of bio
Considers (to a point) ind diffs
Explanation is quite theoretical and cant see it

3. The Cognitive Treatment of Schizophrenia
Cognitive Behavioural Therapy (CBT)
Cognitive behavioural therapy (CBT) can help people with schizophrenia to cope better with the symptoms of hallucinations or delusions.
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4. What is CBT?
Cognitive behavioural therapy (CBT) is based on the idea that most unwanted thinking patterns, and emotional and behavioural reactions are learnt over a long period of time.

5. Psychological Treatment; CBT
The CBT approach to treatment differs slightly from conventional CBT methods. The aims of this therapy are:
To challenge and modify delusory beliefs
To help the patient to identify delusions
To challenge those delusions by looking at evidence
To help the patient to begin to test the reality of the evidence
For example, you may be taught to recognise examples of delusional thinking in yourself
eg – thinking that people what to kill you.
You may then receive help and advice about how you can avoid acting on these thoughts
eg – Rationalizing that people have no reason to want to hurt you. Encouraging you to engage with people in meaningful ways. Allowing opportunities to practice these new skills and share your experiences and reflect on how it felt to engage in positive social interactions.

6. Length of treatment
Most people will require between five to 20 sessions of CBT over the space of six to 12 months.
CBT sessions usually last for about an hour
Been shown to be effective for:
reducing the positive symptoms of schizophrenia,
for reducing relapse and
for enhancing recovery when schizophrenia is diagnosed early

7. An example of a delusional belief
Event
Overhearing someone saying “I know what’s on your mind”
Interpretation
Everyone can read my thoughts
Feeling
Paranoid, scared and believing that others will attack me for my thoughts
Behaviour
Take evasive action – avoiding situations that will bring me into contact with others

8. Psychological Treatment; CBT
Everyone can read my thoughts
CBT strategies try to challenge & help modify delusory beliefs
Identify delusions
Challenge evidence on which delusions are based
Design ‘experiments’ to test reality of this evidence
Drawing diagrams for patients to show links between thinking, behaviour and emotions
Normalising strategies = where patient is taught to understand the nature of schiz. Symptoms
Challenge ‘catastrophising’ beliefs about schizophrenia
Help patient feel that symptoms are understandable and ‘normal’
Overhearing someone saying “I know what’s on your mind”
“think of something now and see if I can read your thoughts”
Chadwick & Lowe (1993) – significant reductions in delusions in 10 out of 12 patients
Helps 70% of patients although other 30% may deteriorate (Kingdon & Turkington, 1996)

9. Turkington et al (2004)
Purpose is to help patients make sense of their environment including delusions and hallucinations
Understanding origins of symptoms can be crucial – if a patient hears voices and believes they are demons, naturally they become afraid. CBT can offer a way / strategy to reduce this anxiety….
What else is this therapist offering / providing?

10. Other research
Sensky et al (2000) found that CBT was effective in treating schizophrenia patients who hadn’t responded to drug treatment
effective for +ive and –ive symptoms
patients continued to improve 9 months after treatment had ended
Lomas talking about Lynch, Laws & McKenna
NHS article – NICE research
Favrod 2006
Bradshaw 1998 – the case of Carol
Read the different pieces of research and complete hand out

11. Evaluation
Evaluation of CBT Don’t sit passively!! Make notes… some good evaluation points are here…

12. Some Evaluation of CBT
Gould et al. carried out a meta-analysis of seven studies and found a significant decrease in the positive symptoms of Sz.
Kuipers et al. found that when combined with antipsychotic drugs there was a lower drop out rate and greater patient satisfaction.
Allows people to function more normally with symptoms, preventing Learned symptoms from developing.
Can be used in conjunction with other therapies
Improves symptoms, recovery and relapse rates
No side effects
CBT for Sz works by generating less distressing explanations for negative experiences rather than eliminate them completely. Shown to be incredibly effective
Doesn’t work for everybody i.e. not suitable when the patient are deluding as they cannot fully engage with the therapy
Not very rational to teach patients to see life through rose coloured spectacles
Reliant on the patient committing to the therapy
Expensive and time consuming

13. Homework Some: On the blog is the Bradshaw complete article
If you would like to use Case Studies as a method for Clinical this is your study you need to refer to
All:
Complete reading around what we have covered this week
Dig out any notes from AS on animal research for next week
Leaflet 
Passport to Success
Some:
Resitting: past paper on the Blog due in week before Easter

14. Extension Apply your knowledge:
You have a friend that you believe has schizophrenia. You have been asked to explain to them why they might have schizophrenia. They also ask you about which treatments you would recommend. Which explanations / treatments would you share with them? Are there any that you would leave out?