Cognitive Behavioural Therapy and Family Interventions for Psychosis

Cognitive Behavioural Therapy and Family Interventions for Psychosis

Psychosocial treatments for schizophrenia are not new in the research

literature. Psychological treatments have been previously used in the

treatment of schizophrenia. For example in terms of behaviour therapy,

operant approaches such as token economy programmes were used in the

1960s and 1970s to improve the behaviour of patients in long stay

hospitals. However, the evidence suggests that the clinical gains were

limited and did not generalise beyond the therapeutic setting and also

did not address delusional convictions (Alford 1986; Himadi et al

1991). Other psychological treatments for schizophrenia can be traced

to early work devoted to studying the impact of the social environment

on mental illness. A plethora of early studies focused on the role of

the family environment in the maintenance of schizophrenia which in

turn led to the concept of expressed emotion (Brown et al 1972; Brown

& Rutter 1996). Family interventions were first developed as a method

for reducing levels of expressed emotion among relatives and are now

recognised as a significant aspect in the treatment of schizophrenia.

This approach marked a paradigmatic shift in the way family members

were viewed by clinicians and has led to efforts to improve

communication between clinicians and carers. Recent years have seen

such cognitive approaches expanded to interest in interventions that

combine the principles of cognitive and behavioural approaches.

However, despite all the research available providing evidence of

their effectiveness, these approaches are not widely available in

routine clinical...

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...nd assertive case management: the social and

independent living skills program of the Brentwood Veterans Affairs

Medical Center. New Directions for Mental Health Services 53:33-41

Annotated further reading

Fadden G 1998 Family intervention. In: Brooker C, Repper J (eds)

Serious mental health problems in the community: policy, practice and

research. Baillière Tindall, London

This chapter provides a comprehensive and up-to-date review of the

research literature on family intervention.

Nelson H 1997 Cognitive behavioural therapy with schizophrenia.

Stanley Thornes Publishers, Cheltenham

This is an excellent book for anyone who wants to develop an

understanding of CBT in the management of psychosis.

*Haddock G, Slade P G 1996 Cognitive-behavioural interventions for

psychotic disorders. Routledge, London