I Would Like To Know More Information On Cbt For A Person Suffering Schizophrenia.
Question: I would like to know more information on cognitive behaviour therapy or other effective counselling therapies for a person suffering from schizophrenia. Thanks, Lee
Answer (1) Lee, CBT is supposed to work through training oneself to think differently about our problems and therefore, end up feeling differently about them. Hopefully better. Because of the frequently delusional, projective and highly variable nature of a lot of Schizophrenic thinking, I would suspect that CBT would be of little use, and possibly even harmful. However, some higher functioning Schizophrenics can certainly use low key regular, contact with someone they trust, who can act as a reality check for them, monitor their medication and help them with the stresses and strains of everyday living. It is usually a mistake to attempt any deep exploratory and highly emotionally charged work with these people, as it tends to mobilise and exacerbate psychotic phenomena and can actually make things worse. Like any other mental illness, schizophrenia occurs in degrees and is manifested in many different ways. It is important to look to the degree and type of functioning as a guide, to determine what the patient can utilise and tolerate.
Answer provided by David White, Psychotherapist
Answer (2) Lee, Schizophrenia is a wide ranging diagnosis with a equally wide range of interventions. My experience has been that if a good therapeutic bond can be established then psychotherapy can be beneficial. Research from both the UK and locally has shown some forms of psychodynamic (like Self psychology, Conversational model) approach can help. My suggestion would be to find a therapist with whom you can develop a good working relationship than one who is trained in a particular therapeutic model.
Answer provided by Philip Wright, Psychotherapist
Answer (3) The evidence base suggests that CBT is an effective treatment for schizophrenia, both for active-phase symptoms (eg, hallucinations) and for negative symptoms and relapse prevention. While the evidence does suggest that medication is the "front-line" treatment, the research shows that CBT has an additional treatment effect to meds, and also that both treatments in conjunction results in a greater benefit than either alone. I can provide you with references if you would like to find out more. I think that (as with most clinical issues of this kind) it is most important that you receive up to date information, from professionals who are well informed and able to provide you with valid information - and then you can make up your own mind. Compared to the first answer you have received, I can certainly say that my own experience has shown great benefits from a CBT-based approach for people suffering from schizophrenia - especially in areas such as increased insight, decreased substance use, general social functioning, reduced hospital admissions, better family relationships, ... I can go on. Sorry if I sound a bit like a scientist from this answer - but basically I think that if you can't show that a treatment works through evidence and research, then why bother? Better not to waste your money and time. CBT certainly is of use, and is not harmful if practiced by someone trained and competent to do so.
Answer provided by Nicholas Rooke, Psychologist
Answer (4) There are a number of different aspects to Schizophrenia. Cognitive Behaviour Therapy can be of assistance in changing people's beliefs about their hallucinations. The general view seems to be that CBT is not as successful as first thought.
The new antipsychotic medications can make a difference to a person's mental state. If a person has insight or understanding into Schizophrenia then this can certainly assist in managing their symptoms.
The literature suggests that social skills training may be helpful. It addresses behaviours such as poor eye contact, unusual delays in response, lack of spontaneity in social situations by role playing in therapy, practising the specific skills, watching videotapes of others and the patient.
Family therapy which works with the patient and the family, is helpful in preventing relapses.
Psychoeducation is also helpful. This is where the person, family or significant other is provided with information about Schizophrenia.
Case management is where a professional is assigned to the person and monitors their mental state, ensures appointments are kept, that medication is complied with, and works with the person with a management or care plan. The plan might identify early warning signs and strategies to put in place before symptoms escalate and possibly result in hospitalization.
Answer provided by Roslyn Kaiser, Counsellor
Answer (5) Hi Lee, I attended a workshop today (14/10/05) at Melbourne University. The topic was Cognitive Behavioural Psychotherapy for Psychosis. The speaker was David Fowler (Prof. of Social Psychiatry and Clinical Psychologist working and practicing in the UK) who presented a wonderful model of CBT from research conducted with more than 3 trials. I came away heartened to know that CBT is clearly very useful and effective and applicable to a wide range of mental illness and the schizophrenias IF understood and used by a compassionate, mature and skillful practitioner. Enough said. Here is David Fowler's email, should you wish to contact him for more information: d.fowler@uea.ac.uk
Answer provided by Brian Whiter, Psychotherapist
