Person-based contextual therapy applied to a complex case of schizophrenia

  1. Vallina Fernández, Oscar
  2. Pérez Álvarez, Marino 1
  3. Fernández Iglesias, Purificación 1
  4. Soto Balbuena, Cristina 1
  5. Perona Garcelán, Salvador
  6. García Montes, José Manuel
  1. 1 Universidad de Oviedo
    info

    Universidad de Oviedo

    Oviedo, España

    ROR https://ror.org/006gksa02

Revista:
Psicothema

ISSN: 0214-9915

Ano de publicación: 2014

Volume: 26

Número: 3

Páxinas: 299-307

Tipo: Artigo

DIALNET GOOGLE SCHOLAR lock_openAcceso aberto editor

Outras publicacións en: Psicothema

Resumo

Background:Psychological therapies are becoming more and more important in schizophrenia, and not as mere adjuncts to medication. The psychotherapy of schizophrenia is taking on a new lease of life in the wake of person-based phenomenological and psychological developments. Method: The case in question was a complex one, with variegated symptomatology that had persisted over many years. Approaching the case from the perspective of person-based cognitive therapy allowed us to understand the psychotic symptoms in the biographical context and to apply a therapy focused on the patient's recovery of her sense of self and of life. Results: At the end of the therapy and throughout the 12-month follow-up, the psychotic experiences had practically disappeared, or ceased to be disturbing, and the patient had become re-integrated in social life. Conclusions: Psychotic symptoms take on meaning in the biographical context. Adopting this perspective can aid the psychopathological explanation of the disorder and provide significant therapeutic help, more focused on recovery. Psychological therapy has shown itself to be viable in complex cases treated within the public-sector healthcare context.

Referencias bibliográficas

  • Abba, N., Chadwick, P., & Stevenson, C. (2008). Responding mindfully to distressing psychosis: A grounded theory analysis. Psychotherapy Research, 18, 77-87.
  • Chadwick, P. (2003). Two chairs, self-schemata and person based approach to psychosis. Behavioural and Cognitive Psychotherapy, 31, 439-449.
  • Chadwick, P. (2006). Person-based cognitive therapy for distressing psychosis. Chichester: Wiley.
  • Chadwick, P., Birchwood, M., & Trower, P. (1996). Cognitive therapy for delusions, voices and paranoia. Chichester: Wiley.
  • Chadwick, P., Hughes, S., Russella, D., Russell, I., & Dagna, D. (2009). Mindfulness groups for distressing voices and paranoia: A replication and randomized feasibility trial. Behavioural and Cognitive Psychotherapy, 37, 403-412.
  • Chadwick, P., Trower, P., & Dagnan, D. (1999). Measuring negative person evaluations: The evaluative beliefs scale. Cognitive Therapy and Research, 23, 549-559.
  • Chadwick, P., Newman, K., & Abba, N. (2005). Mindfulness groups for people with psychosis. Behavioural and Cognitive Psychotherapy, 33, 351-359.
  • Chadwick, P., Trower, P., Juusti-Butler, T., & Maguire, N. (2005). Phenomenological evidence for two types of paranoia. Psychopathology, 38, 327-333.
  • Dannahy, L., Hayward, M., Strauss, C., Turton, W., Harding, E., & Chadwick, P. (2011). Group person-based cognitive therapy for distressing voices: Pilot data from nine groups. Journal of Behavior Therapy and Experimental Psychiatry, 42, 111-116.
  • Figiber, H.C. (2012). Psychiatry, the pharmaceutical industry and the road to better therapeutics. Schizophrenia Bulletin, 38(4), 649-650.
  • García-Montes, J.M., Pérez-Álvarez, M., & Perona-Garcelán, S. (2013). Acceptance and Commitment Therapy (ACT) for delusions. In L. Johns, J. Oliver, E. Morris & C. Joseph (Eds.), ACT and Mindfulness for Psychosis (pp. 112-125). London: Wiley.
  • Gaudiano, B.A., & Herbert, J.D. (2006). Acute treatment of inpatients with psychotic symptoms using acceptance and commitment therapy: Pilot results. Behavior Research Therapy, 44, 415-437.
  • González-Pardo, H., & Pérez-Álvarez, M. (2013). Epigenetics and its implications for psychology. Psicothema, 25, 3-12.
  • Gumley, A., & Schwannauer, M. (2006). Staying well after psychosis. A cognitive interpersonal approach to recovery and relapse prevention. John Wiley & Sons.
  • Haddock, G., McCarron, J., Tarrier, N., & Faragher, E.B. (1999). Scales to measure dimension of hallucinations and delusions: The psychotic symptoms rating scales (PSYRATS). Psychological Medicine, 29, 879-889.
  • Lemos, S., Vallina, O., Fonseca, E., Paíno, M., & Iglesias, M.P. (2012). Tratamientos empíricamente apoyados para los síntomas psicóticos. In F.J. Labrador & M. Crespo (Eds.), Psicología clínica basada en la evidencia (pp. 87-122). Madrid: Pirámide.
  • May, K., Strauss, C., Coyle, A., & Hayward, M. (2012). Person-based cognitive therapy groups for distressing voices: A thematic analysis of participant experiences of the therapy. Psychosis.
  • Melo, S.S., & Bentall, R.P. (2013). "Poor me" versus "bad me" paranoia: The association between self-beliefs and the instability of persecutory ideation. Psychology and Psychotherapy: Theory, Research, Practice, 86(2), 143-163.
  • Morrison, A.P., & Barratt, S. (2010). What are the components of CBT for psychosis? A Delphi study. Schizophrenia Bulletin, 36, 136-142.
  • NICE (2010). Schizophrenia: The NICE guideline on core interventions in the treatment and management of schizophrenia in adults in primary and secondary care (update). National Clinical Practice Guideline, Number 82.
  • Nelson, B., & Sass, L. (2009). Medusa's stare: A case study of working with self-disturbance in the early phase of schizophrenia. Clinical Case Studies, 8, 489-504.
  • Newman, K., Harper, S., & Chadwick, P. (2009). Impact of mindfulness on cognition and affect in voice hearing: Evidence from two cases studies. Behavioural and Cognitive Psychotherapy, 37, 397-402.
  • Pain, M.C., Chadwick, P., & Abba, N. (2008). Clients' experience of case formulation in cognitive behaviour therapy for psychosis. British Journal of Clinical Psychology, 47, 127-138.
  • Pérez-Álvarez, M. (2012). Schizophrenia y cultura moderna: razones de la locura. Psicothema, 24, 1-9.
  • Pérez-Álvarez, M., & García-Montes, J.M. (2012). From neurochemistry to interpersonal chemistry: Towards a psychotherapy of Schizophrenia. In A.J. Lancaster & O. Sharpe (Eds.), Psychotherapy: New Research (pp. 1-21). New York: Nova Science Publishers.
  • Pérez-Álvarez, M., García-Montes, J.M., Vallina-Fernández, O., Perona-Garcelán, S., & Cuevas-Yust, C. (2011). New life for schizophrenia psychotherapy in the light of phenomenology. Clinical Psychology and Psychotherapy, 18, 187-201.
  • Perona-Garcelán, S., García-Montes, J.M., Rodríguez-Testal, J.F., Ruiz- Veguilla, M., Benítez-Hernández, M.M., López-Jiménez, A.M., Pérez-Álvarez, M. (2013). Relationship of absorption, depersonalization and self-focused attention in subjects with and without hallucination proneness. Cognitive Neuropsychiatry, 18(5), 422-436.
  • Sass, L., & Parnas, J. (2003). Schizophrenia, Consciousness and the Self. Schizophrenia Bulletin, 29, 427-444.
  • Skodlar, B., Henriksen, M.G., Sass, L.A., Nelson, B., & Parnas, J. (2013). Cognitive-behavioral therapy for schizophrenia: A critical evaluation of its theoretical framework from a clinical-phenomenological perspective. Psychopathology, 46, 249-265.
  • Stanghellini, G., & Ballerini, M. (2008). Qualitative analysis. Its use in psychopathological research. Acta Psychiatrica Scandinavica, 117, 161-163.
  • Tai, S., & Turkington, D. (2009). The evolution of cognitive behavior therapy for schizophrenia: Current practice and recent developments. Schizophrenia Bulletin, 35, 865-873.
  • The Schizophrenia Commission (2012). The abandoned illness: A report from the Schizophrenia Commission. London: Rethink Mental Illness.
  • Veiga-Martínez, C., Pérez-Álvarez, M., & García-Montes, J.M. (2008). Acceptance and Commitment Therapy applied to treatment of auditory hallucinations. Clinical Case Studies, 7, 118-135.
Fonte de datos: Dialnet