Cognitive-Behavioral Therapy for Schizophrenia
Search Google for cognitive-behavioral therapy (CBT) and you’ll find this: “A type of psychotherapy in which negative patterns of thought about the self and the world are challenged in order to alter unwanted behavior patterns or treat mood disorders such as depression.”
On the surface, it seems unlikely that this type of therapy would be associated with people suffering from schizophrenia, a serious mental disorder affecting approximately one percent of the world’s population. But it may be an effective supplementary therapy to pharmacological treatment for those with the disorder.
Post-hospital care often begins while patients are still in the hospital, and applies the principles of treatment engagement, goal-setting, positive actions and removing roadblocks to recovery (Moran, 2014). It is believed that utilizing these ideas will allow patients to assume more control in their daily lives and allow for a return of functionality where they may previously have lost some.
CBT is considered an effective way to apply these principles and teach the patient how to practice them on their own. It is the most universal treatment in addition to medication in the UK, as well as recommended to become a second frontline treatment by the UK National Health Service (Schizophrenia.com, 2014).
According to the Beck Institute website (2016), “the goal of CBT is to help people get better and stay better.” The website also explains that the therapy is a platform for the therapist and client to work together to change the clients’ thinking, behavior and emotional responses. This ties in with the ideas of treatment engagement and setting goals. Through practicing this, schizophrenia patients feel that they can take more control in their daily lives. Once the barriers of feeling helpless and being defined by their illness are removed, it is easier to move forward. It is an important step in the life of anyone suffering from mental illness to feel hope for the future and be able to achieve some forms of independence.
CBT targeted toward schizophrenia was researched only after it had been proven effective for anxiety and depression, to provide a treatment for the residual symptoms (Kingdon & Turkington, 2006) that remained once the patient was on medication. It is common knowledge that even with compliant pharmacologic therapy, patients still experience both positive and negative symptoms, such as delusions, hallucinations or symptoms similar to depression. Additional symptoms include a reduction in motivation, emotional expression and feeling, and a lack of pleasure and interest in life, among other cognitive impairments affecting memory, thought organization and task priority (Schizophrenia.ca, 2016). Medication side effects such as uncontrollable movements, weight gain, seizures and sexual dysfunction also can be debilitating (Konkel, 2015).
Mental health professionals have reiterated over the years that CBT and medication have been demonstrated to be effective treatments for schizophrenia. According to the UK’s National Institute for Health and Care Excellence (NICE), “almost half of all practitioners, people using mental health services and their families say that CBT is the most important intervention alongside the use of medication” (NICE, 2012).
One study comparing CBT to other forms of psychosocial interventions found that CBT and routine care together were more effective than any of the other therapies examined (Rector & Beck, 2012). The authors acknowledged that there are many flaws in the studies they combined and compared, but it holds promising results that may be tested in more rigorous and controlled studies in the future.