July 22, 2005

Cognitive Behavioral Therapy Limited

A new study suggests that cognitive behavioral therapy may not be as effective as hoped when treating schizophrenia. It has been argued that such therapy was effective for treating the refractory positive symptoms of schizophrenia.

"'Manualized therapy was compared with supportive counseling' in terms of their ability to manage positive symptoms, the scientists said. 'Both interventions were delivered by experienced psychologists over 16 sessions of treatment,' and 'therapy fidelity was assessed by two independent raters.'

'Participants underwent masked assessment at baseline, after treatment and at 6 months' follow-up," according to the report. The 'main outcome measures were the Positive and Negative Syndrome Scale and the Psychotic Symptoms Rating Scale,' and the 'analysis was by intention to treat'" (Biotech Week via NewsRX.com).

The initial post-treatment assessment showed that patients had improved in terms of auditory hallucinations and how aware they were of their illness. But when researchers followed-up on their findings they found that such improvements had not been maintained. In other words, this study showed that cognitive behavioral therapy can give some short-term benefits, but it is questionable how much it helps over the long-term.

This phenomenon needs to be studied further in order for it to be fully understood. It seems that cognitive behavioral therapy is something that helps while it is going on, but does not help much once it is completed.

The source of this story is Biotech Week via NewsRx.com & NewsRx.net

This research study was originally published in the British Journal of Psychiatry (Cognitive-Behavioural Therapy for Refractory Psychotic Symptoms of Schizophrenia Resistant To Atypical Antipsychotic Medication. Randomised Controlled Trial. Br J Psychiatry, 2005;186:324-30).


I don't like to see negative articles on cognitive therapy because that may make people think that it is not an option.
I think that my awareness which is the same thing as cognition has been a great help to me and it takes practice. Luckily for me I have been practicing meditation for a long time I think most have not.
Perhaps the psychologists are going in the wrong direction. Schizophrenics have to be taught how to back out of delusionary thoughts by saying things like, "Its not real" Its a statement of faith because it is impossible for us to know it isn't real.
It gives someone a choice to not go where a delusion is taking them and to stay in the real world. Its hard to do this because it takes being aware of what is going on in one's mind at all times.
Teaching tactics like this will only work for someone who has been through a delusion and made their way out. It only helps with not getting caught in other delusions, not getting someone out of one.
I had to learn most of my tactics on my own, and there should be an easier way to go about it than trial and error. Some might not even know to try tactics. That is where a psychologist can come in.
I have to stress that this is not an alternative to medication but an invaluable tool that should be used along with medication.

Posted by: Sipp at July 23, 2005 04:56 PM

I'm working on an essay for school and am trying to compare the cognitive behavioural therapy for schizophrenia with the medical therapy. I have to say i strongly agree with Sipp's comment, that cog behavioural therapy seems to be "an invaluable tool that should be used along with medication". There are so many options out there for schizophrenics, hopefully one day, a solid cure will be found.

Posted by: Katie at October 28, 2005 03:29 AM

A young schizophrenic in Manchester stabbed a boy he was baby-sitting for when he was in the throes of a delusion and believed the voices he heard that he was Jesus and the boy was Judas.

When things are uncomfortable, or I am feeling paranoid, if I think back on what that young schizophrenic felt - and he was wrong. So I must be wrong too and those perceptions must be wrong. You can't always remove the perceptions but they can lose any power they have over you, you are just indifferent.

Cognitive therapy is like a muscle. Use it or lose it. It's a matter of choice. Your choice.

If someone tells you "it's your illness, there's nothing you can do about it" - you can choose to be overwhelmed and learn to be passive or you can choose to exercise that mental muscle. It's not easy. But like learning to read and write, it's worth the attempt.

Posted by: susanna at August 1, 2006 03:12 PM

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