The application of these tools will be demonstrated by a case study of a service user with psychosis, in conjunction with evaluation and reflection of the care delivered.
During the 1980's the Cognitive Therapist joined forces with the Behaviour Therapist to modify people's inaccurate beliefs.The two therapies merged to work hand in hand, which led to much research being conducted in recent years. This helped to advocate the development of cognitive-behavioural interventions for psychosis (Haddock & Slade, 1996). Psychosocial techniques were developed to help modify medication resistant experiences and claim to be the most promising advancement in the treatment of schizophrenia for many years (Kingdon & Tukington, 1994). The intention was to move closer towards directing therapies for specific symptoms. This in turn would help the service users normalise or accept their experiences, which otherwise would be exceptionally disturbing.
The main assumption behind psychosocial interventions is that, psychological difficulties depend on how people think and interpret events (cognition), how people respond to these events (behaviour), and how it makes them feel (emotions) (Kinderman & Cooke, 2000). In other words, correlations and links are made between the service user's feelings and the pattern of thinking which underpin the distress they experience. This therefore suggests that, the way people feel about a situation or experience depends on what they think about it and how they interpret (Nelson, 1997). In the context of severe and enduring mental illness, the introduction of psychosocial interventions allow us to work with service users who have difficulties with their thoughts, making illogical associations and developing false and sometimes bizarre explanations for their feelings, this causes poor social functioning or withdrawal. The method used with psychosis strengthens the service user's logical reasoning ability against their intuitive feelings, for example, it encourages a split between "I feel/believe/hear". Standards to psychosocial interventions include logical reasoning, evidence for and against distressing beliefs, reality testing and generating alternative explanations (Kingdon & Tukington, 1994).
Psychosocial Interventions in Psychosis
Positive symptoms of psychosis such as hallucinations are often distressing experiences because of the service user's perception of whom or what is responsible. The use of psychosocial interventions can encourage service users to challenge commanding voices in a collaborative manner. For example, in order to limit the power of command auditory hallucinations which threaten bodily harm if the service user intentionally stops the occurrence of an obsessive thought, the service user may develop counter thoughts (Kingdon & Tukin