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Cognitive psychotherapy, a therapeutic method that is normally used in conjunction with behavioural approaches, has been proven to be an effective method in the treatment of a variety of psychological conditions. These conditions include panic attacks, schizophrenia, or even a problem like depression. Sometimes the two approaches intrinsic in this kind of treatment are combined to form its name, as in cognitive-behavioural psychotherapy.
The basic idea in cognitive therapy is the fact that the cognitive aspect of esteem, the way we perceive problems, the world, and other mundane aspects of life like expectations and beliefs are chief determinants of our success in dealing with problems and working towards the realization of our dreams. Schizophrenia is a psychological problem in which the victim suffers distorted perceptions of self, and the world.
This disorder is caused by disordered thinking, which is also a major characteristic of the disorder after it is diagnosed. With this definition of schizophrenia, it is logical that a cognitive approach is employed in the treatment of the problem 3. This is because medical interventions, which are associated with alleviation of psychotic thought processes, would jeopardize therapy.
History of treatment
The treatment of schizophrenia has used behavioural approaches for many years. This has, however, been implemented through programs for psychosocial rehabilitation as opposed to an approach biased on individual treatment. The programs for psychosocial rehabilitation were very expensive and thus they were either based in hospitals, funded by the government, or they were funded by NGOs.
This led to group behavioural treatment that was offered by providers with mediocre expertise. Although some success in was realized by these programs, the real value that can possibly come with behavioural treatment was hidden by the massive structure of the rehabilitation programs 5. This is because the programs were, to a large extend, dissimilar, and thus it was hard to evaluate their comparative effectiveness.
The cognitive component
Among the major symptoms for schizophrenia is the habitual misinterpretation of happenings. The patient may not change after the misinterpretations are explained clearly to him/her 4. This may occur due to complications in the biological set-up of the client. Cognitive therapy can also work in a case where the psychologist comes up with a tailor-made solution for his/her patient that consists of a way of dealing with life problems in the patient’s state of mind.
That is, the doctor will understand the extent of the imperceptions of his/her patient and make the patient use his/her imperceptions in the recovery process 2. The intention is to make the client to learn from experience, after the therapy, for him/her to make the necessary adjustments.
After treatment, a patient is not expected to recover completely, but the manner in which he/she handles issues in life is expected to change for the better. The patient is also expected to have a sense of autonomy, and make good decisions in times of crisis. Thus the patient will be able to cope with stress positively and avoid unrealistic mentalities.
The behavioural component
The behavioural therapeutic option for schizophrenia operates under the assumption that certain life skills have the ability to make a person solve life problems with more ease, and live a more fulfilling life. It uses the fact that the development of psychosocial skills in human beings is as a result of experience.
Thus the saying that people learn from their past mistakes, and success in solving life problems is applicable in this kind of therapy. From the fact that different people have different experiences in life, it follows that some people will be able to learn skills better than others 3.
Another difference that normally occurs in the learning capability of individuals is the extent to which an individual can learn from his/her past experiences. It is common knowledge that for a person to learn from experience, he/she has to have the capability to critically analyze the experience. The individual must, therefore, be able to point out the effective and ineffective methods that he/she used to solve the problem.
This should be followed by a strategic replacement of the ineffective methods with better methods and retention of the effective methods. Since different people have different abilities to analyze experiences, there are significant differences in the abilities of people to use past experiences as stepping stones to success. The role of a therapist here would be to help his/her client to correctly analyze his/her experiences, and suggest changes that could improve the problem solving ability of the patient.
Unfortunately, we also adopt maladaptive approaches to problems in cases where the approaches are able to minimize our pain or embarrassment caused by a given problem. This is, in fact, the reason why schizophrenia keeps on getting worse in its patients. The maladaptive practices that the patients develop for specific problems act as a haven from the problems, and thus the patient may keep on adopting other negative responses to feel secure in a problem 1.
It can thus be argued that development of maladaptive approaches to problems is the root cause of cognitive distortions which, in turn, render an individual unable to assess cause and effect in relation to problems.
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This is actually the main reason why behavioural therapy and cognitive therapy go hand-in-hand. To evidence the necessity of the cognitive-behavioural psychotherapy individuals with schizophrenia, schizophrenic individuals are unable to make correct assessments of their problems, and thus they cannot perform a reliable cause-effect analysis.
They are also characterized by an inability to learn from experience due to the characteristic distortions associated with their thinking. Therefore, the behaviour therapy that is accorded to them by a therapist is meant to help them learn social and decision making skills. It also makes them learn how to apply the aforementioned two skills in solving their personal problems.
As evidenced in the discussion above, the combination of cognitive therapy and its behavioural counterpart is efficient in the treatment of schizophrenia. This is primarily because the disorder itself has cognitive components as well as behavioural components, and an application of either of the two without the other will not be effective. For instance, schizophrenic patients have distorted and disorganized mental frames.
This is a cognitive component of the disorder that cannot be effectively treated by behavioural therapy. On the other hand, schizophrenic patients are normally unable to effectively learn from their past because of their poor analytical skills. This is a behavioural component of the disorder that cannot be effectively treated solely by cognitive therapy. It is thus of essence that schizophrenic patients are exposed to cognitive-behavioural therapy in order for their situation to improve.
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- Cormac, I. Cognitive behavior therapy for schizophrenia. California: Wadsworth Publishing; 2003.
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- Gary, M. Cognitive behavioural therapy for schizophrenia. 2009. Web.
- Weiden, P. Cognitive Behaviour Therapy for Schizophrenia. Reviews and Overviews. 2006. Web.