Methods of Modifying Behaviour
Cognitive Behavioural Therapy
Irrational Thinking
- When CBT proved to be so successful in the treatment of disorders like depression, researchers
wondered how effective it would be in treating schizophrenics who were experiencing irrational
thoughts despite appropriate doses of anti-psychotics.
- The purpose of CBT is to help an individual consider and organise any irrational thoughts.
- While CBT cannot prevent hallucinations or delusions, is can help manage thinking and thus cope
with the symptoms.
- CBT makes clients aware of the connections between disordered or jumbled thinking and their
illness.
- For schizophrenics who hear voices, CBT may help them attribute these voices as originating in
their own mind, rather than from an external force.
- The therapy also challenges interpretations of events, asking individuals to provide evidence.
- CBT deals mainly with the positive symptoms of schizophrenia, but also helps individuals to
become more self-reliant when dealing with their illness and can have a knock-on effect on
negative symptoms.
- Laura Smith et al. (2003): identified key treatment components when using CBT to treat SZ.
Key Component: Engagement Strategies
- It is important for therapists to build a rapport with their clients, as they may be suffering
paranoia from their illness, or have had negative experiences with professionals in the past.
- Preliminary sessions are held to allow the client to discuss any worries as well as symptoms of
particular concern.
- The therapist and client will also discuss any ‘natural coping strategies’ the client is already using
so they can appreciate that they are experts in their own symptoms.
- Clients are encouraged to trace back to the origins of their symptoms in order to gain insight into
the way in which they may have developed.
- Motivational Interviewing identifies the client’s goals and values and shows how looking after
themselves, taking their medication and engaging in therapies can help them reach that goal.
Key Component: Psychoeducation
- Psychoeducation is essentially learning about one’s own illness.
- It does not put blame on the client, but it highlights how it is a condition like any other illness
and that there is room for self-management of symptoms.
- Psychoeducation serves three main purposes:
• Decatastrophises and normalises psychotic symptoms, offering alternative explanations to
the client’s prior understanding.
• Increases the client’s insight into circumstances when symptoms occur.
• Allows the therapist to assess the client’s own understanding of their illness.
- CBT, the word ‘client’ is used as opposed to ‘patient’ to express the control the person in
treatment has.
Key Component: Cognitive Strategies
- The ABC model is used in CBT in order to challenge irrational thoughts.
• A stands for activating event, the event which leads to irrational thoughts or feelings.
• B stands for beliefs, which can be irrational or rational depending on the person and their
circumstances.
• C stands for consequences, the behaviours which are a result of the irrational beliefs.
- The model was extending in therapy to include dispute and effect. Disputes include empirical,
logical or pragmatic. The effect is the beliefs becoming rational.
Cognitive Behavioural Therapy
Irrational Thinking
- When CBT proved to be so successful in the treatment of disorders like depression, researchers
wondered how effective it would be in treating schizophrenics who were experiencing irrational
thoughts despite appropriate doses of anti-psychotics.
- The purpose of CBT is to help an individual consider and organise any irrational thoughts.
- While CBT cannot prevent hallucinations or delusions, is can help manage thinking and thus cope
with the symptoms.
- CBT makes clients aware of the connections between disordered or jumbled thinking and their
illness.
- For schizophrenics who hear voices, CBT may help them attribute these voices as originating in
their own mind, rather than from an external force.
- The therapy also challenges interpretations of events, asking individuals to provide evidence.
- CBT deals mainly with the positive symptoms of schizophrenia, but also helps individuals to
become more self-reliant when dealing with their illness and can have a knock-on effect on
negative symptoms.
- Laura Smith et al. (2003): identified key treatment components when using CBT to treat SZ.
Key Component: Engagement Strategies
- It is important for therapists to build a rapport with their clients, as they may be suffering
paranoia from their illness, or have had negative experiences with professionals in the past.
- Preliminary sessions are held to allow the client to discuss any worries as well as symptoms of
particular concern.
- The therapist and client will also discuss any ‘natural coping strategies’ the client is already using
so they can appreciate that they are experts in their own symptoms.
- Clients are encouraged to trace back to the origins of their symptoms in order to gain insight into
the way in which they may have developed.
- Motivational Interviewing identifies the client’s goals and values and shows how looking after
themselves, taking their medication and engaging in therapies can help them reach that goal.
Key Component: Psychoeducation
- Psychoeducation is essentially learning about one’s own illness.
- It does not put blame on the client, but it highlights how it is a condition like any other illness
and that there is room for self-management of symptoms.
- Psychoeducation serves three main purposes:
• Decatastrophises and normalises psychotic symptoms, offering alternative explanations to
the client’s prior understanding.
• Increases the client’s insight into circumstances when symptoms occur.
• Allows the therapist to assess the client’s own understanding of their illness.
- CBT, the word ‘client’ is used as opposed to ‘patient’ to express the control the person in
treatment has.
Key Component: Cognitive Strategies
- The ABC model is used in CBT in order to challenge irrational thoughts.
• A stands for activating event, the event which leads to irrational thoughts or feelings.
• B stands for beliefs, which can be irrational or rational depending on the person and their
circumstances.
• C stands for consequences, the behaviours which are a result of the irrational beliefs.
- The model was extending in therapy to include dispute and effect. Disputes include empirical,
logical or pragmatic. The effect is the beliefs becoming rational.
