NICE Guidelines for CBTp in Psychosis
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Questions and Answers

What is the recommended duration of sessions for CBTp?

  • 30-36 sessions
  • 12-18 sessions
  • 16-24 sessions (correct)
  • 8-12 sessions

    • Which of the following is NOT one of the main mechanisms underlying delusions?

  • Psychological resilience (correct)
  • Negative self-belief
  • Reasoning bias
  • Sleep dysfunction

    • What approach does the Feeling Safe program utilize in its treatment of persecutory delusions?

  • Group therapy sessions
  • Medication administration
  • Creating new memories (correct)
  • Hypnotherapy techniques

    • What is a characteristic feature of the principles of CBTp?

    <p>Collaborative/shared goal</p> Signup and view all the answers

    Which statement best describes the use of technology in treating patients with psychosis?

    <p>Virtual reality is being explored to treat specific phobias in psychotic patients.</p> Signup and view all the answers

    What challenge is associated with the effectiveness of CBTp?

    <p>Its effectiveness is often debated, showing weak to moderate results.</p> Signup and view all the answers

    In CBTp, what does 'active involvement choice' refer to?

    <p>Patients have a say in their treatment options and processes.</p> Signup and view all the answers

    What aspect of psychosis does the statement 'sane reaction to insane circumstances' refer to?

    <p>Psychosis is a response to external events.</p> Signup and view all the answers

    What is one of the main goals of CBTp?

    <p>To improve functioning and reduce distress</p> Signup and view all the answers

    Which aspect of the Feeling Safe program enhances its effectiveness?

    <p>Creating new memories through structured sessions</p> Signup and view all the answers

    How does the 'talking with voices' approach benefit patients?

    <p>It provides an opportunity for patients to challenge their perceptions</p> Signup and view all the answers

    Which of the following is a challenge in delivering CBTp effectively?

    <p>The high demand for CBTp outweighs available therapists</p> Signup and view all the answers

    Which mechanism is primarily targeted by psychological interventions in delusions?

    <p>Addressing worries and safety behaviors</p> Signup and view all the answers

    What role does collaboration play in the principles of CBTp?

    <p>It fosters shared goals and therapeutic engagement</p> Signup and view all the answers

    What is a primary focus of the NICE guidelines regarding CBTp?

    <p>To offer CBTp to all individuals with psychosis or schizophrenia</p> Signup and view all the answers

    What is a characteristic of persecutory delusions?

    <p>They are ungrounded beliefs that involve feelings of being watched or harmed</p> Signup and view all the answers

    What is a key focus of the NICE guidelines regarding the delivery of CBTp?

    <p>It should be delivered on a one-to-one basis for a minimum of 16 sessions.</p> Signup and view all the answers

    Which principle of CBTp promotes the patient's engagement and therapeutic relationship?

    <p>Collaboration</p> Signup and view all the answers

    What is the purpose of the Feeling Safe program in the context of CBTp?

    <p>To create new memories and enhance feelings of safety for individuals with persecutory delusions.</p> Signup and view all the answers

    What does the term 'abberent salience' refer to in the context of talking with voices?

    <p>How individual appraisal influences the distress of hallucinations.</p> Signup and view all the answers

    What main challenge is noted regarding the accessibility of CBTp?

    <p>Availability of services is less than 5% for eligible patients.</p> Signup and view all the answers

    How does CBTp aim to help individuals with psychosis improve their functioning?

    <p>By promoting self-monitoring and alternative coping strategies.</p> Signup and view all the answers

    Which of the following is a characteristic of persecutory delusions?

    <p>Unfounded beliefs where individuals feel they are being targeted.</p> Signup and view all the answers

    What is a potential benefit of using technology, such as VR, in treating psychosis?

    <p>It allows safe engagement with feared situations for patients suffering from agoraphobia.</p> Signup and view all the answers

    What is a key component of the Feeling Safe program's treatment protocol?

    <p>Creation of new memories</p> Signup and view all the answers

    Which of the following best describes the nature of paranoid thoughts in psychosis?

    <p>They can occur along a continuum.</p> Signup and view all the answers

    What is one of the main challenges associated with implementing the Feeling Safe program?

    <p>Lack of trained therapists in the community</p> Signup and view all the answers

    How many sessions does CBTp typically involve?

    <p>16-24 sessions</p> Signup and view all the answers

    What does 'normalizing approach' in CBTp primarily aim to achieve?

    <p>Validation of patients' experiences</p> Signup and view all the answers

    Which option describes the accessibility challenge of CBTp mentioned in the guidelines?

    <p>Accessibility falls below 5% of patients.</p> Signup and view all the answers

    What is the primary focus of active involvement choice in CBTp?

    <p>Patient engagement in treatment decisions</p> Signup and view all the answers

    What is one of the key elements that contributes to the efficacy of the Feeling Safe program?

    <p>Establishing a therapeutic alliance</p> Signup and view all the answers

    Study Notes

    NICE Guidelines for CBTp in Psychosis

    • Recommendation: Offer CBTp to all individuals with psychosis or schizophrenia, starting during the acute phase or later.
    • Delivery: Delivered individually in at least 16 sessions.
    • Treatment Manual Focus: Aims to establish links between thoughts and re-evaluate perceptions.
    • Key Components: Includes elements like self-monitoring of thoughts, feelings, and behaviors; promoting alternative coping strategies; reducing distress; and improving functioning.
    • Efficacy Debate: Current evidence regarding effectiveness is debated, with some questioning whether it's been "oversold" and the effects are small.

    Principles of CBTp

    • Session Duration: Typically 16–24 sessions.
    • Relationship Focus: Collaborative and recovery-focused approach, emphasizing an engaging therapeutic relationship.
    • Normalization: Aims to normalize experiences.
    • Appraisal Evaluation: Evaluates and challenges maladaptive thought patterns.
    • Active Patient Involvement: Encourages active participation and choice.
    • Between-Session Tasks: Includes tasks patients complete outside of sessions.

    Understanding Psychosis

    • Perspective: Psychosis is considered a "sane reaction to insane circumstances." It causes distress and disruption, but the experiences are real and significant to the person experiencing them.
    • Continuum: Paranoid thoughts exist on a continuum, or hierarchy.
    • Delusions: Unfounded or unusual beliefs; examples include persecutory delusions (“someone is watching me”).
    • Persecutory Belief Mechanisms: Worry, low self-belief, anomalous experiences, sleep issues, bias in reasoning, and safety behaviors underlie these beliefs.

    Challenges of CBTp

    • Effectiveness: Treatment effectiveness is often reported as weak to moderate.
    • Accessibility: Limited access to services (less than 5% of patients).
    • NHS Policy: Requires consideration of relevant NHS policies.
    • Symptom Focus: Often a complaint-oriented approach (e.g., addressing specific delusions or hallucinations).

    The Feeling Safe Program

    • Focus: A specific branch of CBTp targeting persecutory delusions (feelings of being unsafe).
    • Approach: 20 sessions focused on creating new memories and addressing sleep issues, worry, and lack of confidence.
    • Effectiveness: Widely considered one of the more effective treatments.
    • Key Elements: Emphasizes a strong therapeutic alliance and befriending.

    Talking with Voices

    • Compassionate Approach: Aims to foster compassion for hallucinatory experiences (voices).
    • Appraisal: Emphasizes that appraisal determines whether or not the experiences are distressing.

    Technology and VR Therapy

    • GameChange Trial: Uses VR to treat psychosis patients with agoraphobia (social withdrawal).
    • Advantages: Increased patient willingness to participate in difficult situations; opportunities for graded exposure; learned skills transfer to real-world situations; increased treatment accessibility; and more engaging therapy.
    • Treatment Structure: Six 30-minute sessions using automated treatment, with a therapist present. Encourages patient immersion in various scenarios (from therapist's office to everyday situations with varying difficulty).

    Opportunities for Prevention

    • Mechanism-Based Treatment: Expanding research on the mechanisms underlying symptoms like worrying, sleep difficulties, and more.
    • Causal Mechanism Targeting: Going beyond symptoms to target the root causes of these mental health challenges.
    • Sleep Intervention: The example of SleepWell program highlights the potential of interventions (sleep) impacting psychosis symptom expression.

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    Description

    This quiz covers the NICE guidelines for Cognitive Behavioral Therapy for psychosis (CBTp), focusing on its recommendations, delivery methods, and key components. Explore the efficacy debate surrounding CBTp and its principles, including session structure and therapeutic relationships. Enhance your understanding of CBTp and its application in treating psychosis and schizophrenia.

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