PSYCHOLOGICAL THERAPIES: CBT STRESS MANAGEMENT

Akaash Patel

AN OUTLINE OF STRESS MANAGEMENT WITH CBT

Stress Management involves a detailed evaluation of the problems and experiences that an individual is having.

Once these problems have been identified, the therapist and the patient work together to develop various methods with which to deal with these problems.

AN OUTLINE OF STRESS MANAGEMENT WITH CBT - STRATEGIES

After identifying the problem, the therapist and the patient develop potential strategies to combat this (Bennett 2006), This could include techniques like:

Distractions from intrusive thoughts or challenging their meanings. Increasing or decreasing social activity, as a means of distracting the patient from obtrusive thoughts or bad moods. Using breathing or other relaxation techniques to help the patient to relax.

HOW SCHIZOPHRENIA CAN BE AFFECTED BY CBT-SM

McGorry randomly allocated such individuals to either:

A needs based intervention lasting 6 months

Low dose Risperidone therapy combined with CBT. (Risperidone is an atypical neuroleptic)
By the end of the treatment 36% of people in A) had a first episode psychosis compared with just 10% in B).

A CLEAR EXPLANATION OF RESEARCH EVIDENCE THAT SUPPORTS/WEAKENS THE USE OF STRESS MANAGEMENT
Research could include McGorry et al., whose study accumulated results that 36% of people who were in a supportive psychotherapy which focuses on family, social or work issues, had a first episode psychosis. This is in comparison with the 10% of people who had a first episode psychosis in the condition where a low dose risperidone therapy was combined with CBT (referred to as a specific preventive intervention). This supports the fact that CBT-SM is at least more effective than any alternative psychological therapy.

A CLEAR EXPLANATION OF RESEARCH EVIDENCE THAT SUPPORTS/WEAKENS THE USE OF STRESS MANAGEMENT

Other studies include Tarrier et al.s study into whether CBT-SM combined with a drug therapy is more useful in comparison to solely a drug therapy After 20 weeks of treatment, those patients with the CBT-SM treatment showed a greater improvement than those in the counselling group, whereas those in the drug group made only slight deteriorations. One-third of those receiving CBT-SM achieved a 50% reduction in psychotic experiences, compared to a 15% reduction in the counselling group. However, in the two year follow up, the CBT-SM groups advantage had vanished, although both this group and the counselling group were better off than the sole drug group.

IDAS - ETHICAL ISSUES

Massive ethical issues because CBT involves delving into personal thoughts and personal information.

Patients may feel uneasy doing this so informed consent, the right to withdraw and anonymity have to be enforced.

IDAS - RELAPSING AND READMISSION

One of the problems with the CBT approach to schizophrenia is the likeliness of relapses. Relapses can potentially ruin the process of CBT as it may force the patient to quit due to obvious emotional grievances.

In chronic patients, CBT doesnt reduce the likelihood of relapse or readmission. However, does produce significant improvement in mental state