Is CBT useful in treating schizophrenia?

Question

Hello doctor,

I have a case that was assigned to me in school, and I want to seek help from doctors. My case is about a girl who has schizophrenia and was diagnosed very early. She shows all the symptoms, like hallucinations, hearing voices, hurting other people, and talking to people who are not there. My questions are as follows. How can this person get counseled? Is CBT useful? If she does not seek help, what would happen to her? How can I help her if I was a counselor? What approaches can I use during our sessions and why? And lastly, what is the possible outcome?

Answer 1

Hi,

Welcome to icliniq.com.

CBT is usually not useful in schizophrenia when the patient is having fulminant and active symptoms of schizophrenia such as delusions and hallucinations. The prerequisites for CBT (cognitive behavioral therapy) are,

1. The patient should be motivated for therapy.

2. The patient should understand the therapeutic alliance between the therapist and himself.

3. The patient should have good frustration tolerance.

4. The patient must realize that the symptoms are because of his/her maladaptive thoughts, feelings, and behavior.

So in your case, the treatment of choice is drug therapy along with supportive treatment. As far as the prognosis is concerned, it depends upon the following:

1. The response to treatment.

2. Good family support.

3. The age of onset, a very early start is a bad prognostic factor.

4. Treatment compliance.

5. Employment status.

6. The family history of mental illnesses.

7. Type of schizophrenia.

Thank you.