May 13, 2003 

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Cognitive Behavioral Therapy (video)
March 11, 2003

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Interviewees: Constance Lieber, mother; Louis Mullen, patient; Richard Warner, Mental Health Center at Boulder County; Philippa Garety, King's College, London, UK.

Video is 1 min 38 sec long. Please be patient while it loads enough to start playing.

Produced by Sanjanthi Velu

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Understanding Voices

Facts about Schizophrenia

Useful Schizophrenia Links

While neuroscientists look for the cause of schizophrenia in the brain, psychologists are looking for ways other than medication to help people make sense of and deal with the voices they hear.

And as this ScienCentral News video reports, a therapy adopted in Britain seems to have the answer.

Reality Check

Unreal but strongly held beliefs, delusions and hallucinations are characteristic of someone suffering from schizophrenia. This devastating mental illness distorts the thinking processes of its victims. Schizophrenics may hear voices telling them that someone is out to harm them, or they may feel that their thoughts are being broadcast for everyone to hear, according to Richard Warner, medical director at the Mental Health Center at Boulder County in Colorado.

Currently, the most widely available treatment is a variety of medications. But Warner says they are not completely effective for everyone, and in fact can be ineffective for many. He points out that, “only one of the newer drugs really works on what we call ‘treatment-resistant schizophrenia’—[for which] the other drugs don’t work—and that’s Clozapine.” But he adds that like all other schizophrenia drugs, even this has negative side effects like weight gain, seizures and diabetes.

Now some psychologists in the United Kingdom have shown that schizophrenics can get a reality check by talking in detail about their feelings and experiences. They found that, when combined with medication, a therapy known as cognitive behavioral therapy (CBT) can help schizophrenics make sense of their experiences.

Philippa Garety, professor of clinical psychology at King’s College in London, says that the most disturbing thing about schizophrenia is that “your own thoughts become experienced as not your own thoughts.” She explains that CBT, which incorporates in-depth discussions with behavioral therapy techniques, has been found to be more effective than any other type of psychotherapy for treating schizophrenia. Behavior therapy works under the premise that abnormal behavior is learned and therefore can be unlearned. So they help the patient gain confidence and become more assertive and at the same time they train them to relax. Behavioral therapy, when combined with in-depth discussions, helps patients to make sense of their strange experiences, think about them in a different way, and gradually become less fearful of them.

While CBT is used to treat depression and anxiety in the United States, Warner says that so far it is not a treatment option for schizophrenia.

Making Sense of Experiences

Garety and her colleagues in the U.K. have been using CBT alongside medication, and have seen much better results in those patients compared with others who were only taking medication. CBT works on the general principal that everyone has to make sense of his or her experiences. Garety says, “We can talk with people about their delusions and hallucinations and help them make more sense, perhaps, of what’s been happening to them. Help them develop ways of dealing with [their hallucinations] and thinking about them.” So therapists have in-depth discussions with patients about their experiences and the voices they hear and “help them explore alternate interpretations” of the beliefs they have already formed in their minds.

Since the therapy has shown a lot of success in the U.K., Warner has invited Garety and her colleagues to train the staff at the Mental Health Center at Boulder County. Warner is confident that the positive results of CBT will soon lead to more widespread use of the therapy in the United States.

Garety’s research was supported by United Kingdom Department of Health and The Wellcome Trust.

by Sanjanthi Velu

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