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Schizophrenia and Cognitive Therapy

cognitive therapyBeing diagnosed with schizophrenia can be devastating. While there is treatment, it may come with a wide range of side-effects. Medicines, although generally effective, can make you gain weight, feel drowsy, and cause medical problems.[1]

Since the 1950s, schizophrenia has been treated with antipsychotic medicines.1 However, this has caused many mental health clinicians to fall into a routine, simple strategy treatment for those with the diagnosis: medicine.1 While there isn’t a doubt that these medicines make a positive difference, reducing hallucinations and making relapse less likely, it counts on the patient sticking to their medication schedule.1

However, medication adherence is very low in patients with schizophrenia.1 Some don’t accept their illness, but a majority don’t want to deal with the unpleasant side effects of the medicines.1 Oftentimes, the side effects are worse than the symptoms they are designed to treat.1 After six months, approximately 50 percent of patients no longer follow their prescription, taking their medicine occasionally or not at all.1

However, clinicians have relied upon this form of treatment for decades, which motivated a clinical trial to investigate another form of treatment: cognitive therapy.1 A team, led by Professor Anthony Morrison of the University of Manchester, randomly assigned a group of patients with schizophrenia—all of whom opted out of medication management—to either a treatment as usual group or a treatment as usual plus a course of cognitive therapy group.1 Treatment as usual covered a range of non-pharmaceutical care, while cognitive therapy was given on an average of 13 sessions over nine months, plus four booster sessions over the next nine months.1

Results showed that the drop-out rates of the cognitive therapy group were low, and its efficacy in reducing symptoms of psychosis was comparable to medicine.1 Cognitive therapy for schizophrenia is centered around the idea that patients should be encouraged to talk about their experiences, as a patient with every other mental disorder would.1 In cognitive therapy, psychosis is not a biological illness that one either does or does not have—it is viewed as a severe instance of thoughts and feelings that many undergo from time to time.1

The patient and cognitive therapist work together to develop a model of the causes of the psychotic experiences and why they are recurring.1 As these factors vary from person to person, the findings are used to guide their individualized treatment.1 While cognitive therapy is in its early days, it has far to go, but success to report.1

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