Psychological Disorders Diagnosis and Treatment

¶ … Diagnosis and Treatment of Psychological Disorders

Cognitive Behavioral Therapy (CBT) Has Been Increasingly Used In the Treatment of Psychosis over the Last 10 To 15 Years. Describe CBT for Psychosis and Evaluate the Evidence for the Effectiveness for This Intervention in Treating Psychosis

Cognitive Behavioral Therapy's (CBT's) application to psychosis has, of late, been intensely debated. A number of independent psychologists and health organizations are proposing diverse interpretations with regard to what CBT in psychosis treatment really refers to. For example, the National Institute for Clinical Excellence proposes CBT with a small amount of evidence, whereas Maddox (2014), a psychologist, maintains that psychosis denotes a broad or umbrella term applied to a group of symptoms, which are divided into negative or positive. This classification does not imply that some symptoms are bad while others are good; rather, the intention is expressing that some symptoms add a new element, while others take away an element. Positive symptoms constitute those which add a kind of unusual experience (such as delusions, i.e., having strong faith in things, which appear nonsensical to others, or hallucinations, i.e., seeing things others aren't able to see). Negative symptoms, on the other hand, deal with some elements the individual is deprived of (such as, lack of motivation (avolition), emotion, or enjoyment (anhedonia). Multiple researches have indeed shown that CBT for psychotics can assist them in leaving behind some experiences or behaviors responsible for their indulgence in bad behaviors or activities.

Numerous other academic works and reviews prove that CBT in treating psychotics reduces their symptoms, including hallucinations and delusions, in addition to some mental processing correlates of the positive symptoms. These findings explicitly indicate that CBT treatment for psychotics in functioning levels, low mood, and anxiety levels, come under other benefits the patients can achieve. Fundamentally, CBT's intent is to treat functional inefficiencies, such as distress, which are linked to psychosis. Dr. Maddox (2014) states, in this regard, that the goal of CBT is not always to stop a patient from, say, hearing voices; rather, it may change the patient's perception of the voices, lending a less threatening, and different, meaning to them.

While studying CBT in the context of psychosis treatment, the foremost step to be taken is attempting to identify the different kinds of strange experiences an individual undergoes, as well as the precise time frame of occurrence of these experiences. The most helpful step for therapists will probably be recognizing the aims and goals of individual patients while going into therapy. Lovell (1997) and Velpry (2008) maintain that the perspective of patients isn't independently confessed by them; rather, it is in, and influenced by, a context, which is why, if patients fail to display even a small degree of independence in the course of therapy, they won't recover easily.

Effectiveness of this Intervention in Treating Psychosis

As per the National Institute for Clinical Excellence (NICE, 2002), an assessment of CBT has proven that it is highly economical. Many clients who have been administered this therapy have displayed huge changes within short spans of time. Gould, Bolton, and Mueser (2001) are of the view that CBT is the only therapy that has an immensely short gap of follow-up for chronic schizophrenics. Turkington, Kingdon, and Turner (2002), claim that CBT can be effectively employed in community settings. Their research, which was in the form of a case study, entailed CBT training in psychosis for community nurses specialized in the field of psychiatric nursing, for a 10-day time period. While analyzing study result, the researchers found that CBT was effectively implemented by the trained nurses in reducing depression and general symptoms, and offering insight improvement. CBT seems to work for psychotics having an average 12-15% dropout rate; it also seems to be a safe treatment option (Turkington et al., 2002). Moreover, hallucinations and other such psychotic symptoms, which are associated with gradual delusions or trauma, can be treated through brief CBT administration. CBT specialists administer anywhere between 20 and 50 CBT treatment sessions in such psychotic cases, effectively curing the patient. The treatment method is considered to have a high success rate among patients with various types of psychosis, as previously performed studies have proven zero cases of patient indulgence in violence, agitation, or suicidal ideation. This fact suggests that CBT may be the safest mode of treatment for individuals suffering from psychosis.

Hofmann, Asnaani, Fang, Sawyer, and Vonk (2012) conducted a study on CBT's efficiency. Their research produced comprehensive information regarding the degree of effectiveness of cognitive behavioral therapy in treating different health issues. The team carried out a meta-analysis of 269 reviews for evaluating CBT efficiency in treatment of depression, substances use, etc. The study can be, aptly, considered as the latest and most exhaustive assessment of CBT. As per study findings, CBT could successfully treat substance abuse, particularly nicotine and marijuana abuse. This proves CBT's efficiency in positively impacting symptoms of these disorders. Further, CBT proved to be a powerful tool in anxiety disorder treatment, in spite of a few, minor noticeable problems, particularly with regard to social disorders. Saini (2009) asserts that CBT successfully deals with the issues of aggression and anger. However, some well-controlled researches are necessitated for determining the CBT's exact level of efficiency, prior to drawing any absolute conclusions. Hoffman and colleagues reveal, in their study, that CBT is capable of treating various psychosis issues, including pediatric disorders. Their meta-analysis proves remarkable advantages of employing CBT for pediatric problems, over the application of pharmacological methods. In this meta-analysis, the authors performed a number of comparisons between CBT and other treatment methods by the use of eleven studies. Out of these, seven studies found that CBT's response is higher than other therapy forms. Only one of the reviews, carried out by Leibig and Leichsenring (2003), through psychodynamic orientation, recorded lower CBT response rate compared to other modes of treatment.

Conclusion

To sum up, it is revealed that CBT is an effective and efficient mechanism in the treatment of all sorts of psychosis issues. Clearly, the therapy works very successfully, particularly in the treatment of anxiety disorders. In spite of all the aforementioned evidences, there is room for further, high quality research into this topic for the purpose of investigating CBT's actual benefits. There are a few CBT-related issues, which are questionable, warranting further studies .The adoption of adequate control groups must be stressed for supporting production of more efficient results. In spite of these minor challenges, there is great potential for CBT in the arena of psychosis treatment. As per Wilson and Racham (2008), there has been a marked improvement in the availability of psychological treatment interventions by UK's National Health Service than in other nations, particularly those in the developing world, which are yet to try CBT. As scholars in the field strive hard to come up with novel means of tackling psychotic symptoms through CBT application, it is past the time for healthcare organizations to recommend this method for treatment of all types of psychosis, rather than administering drugs. The nations that haven't yet taken a step towards adopting CBT must be made aware of the significance of practicing CBT for bringing about a decrease in unnecessary psychotic ailments, which can, through effective therapy, be easily eliminated.