Single Subject Design Presentation 3

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Published on April 26, 2014

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Treating Cognitive Dysfunction in Adults with Schizophrenia using Cognitive Behavioral Therapy in Conjunction with Psychoeducation : Treating Cognitive Dysfunction in Adults with Schizophrenia using Cognitive Behavioral Therapy in Conjunction with Psychoeducation Natashia Nicole Lee Georgia State University Methods of Community Research Spring Semester 2014 Introduction and Statement of the Problem: Introduction and Statement of the Problem What is Schizophrenia? A mental disorder that it characterized by the inability of an individual to distinguish from reality and delusional thoughts Can effect thoughts, moods, behavior Individuals experience higher levels of anxiety How does Schizophrenia Impact an Individual?:  How does Schizophrenia Impact an Individual? Positive Symptoms Delusions Thought disorders Hallucinations Negative Symptoms Lack desire and/or motivation Antisocial behavior Blunted affect Proposed Intervention : Proposed Intervention Therapeutic approached to treatment are becoming more popular Cognitive Behavioral Therapy focuses on helping the individual recognize the impact of their thoughts, the validity of the beliefs that may be present during a psychosis and how to view these events and beliefs more objectively Psychoeducation helps the individual understand the biology of the illness and has shown to increase the willingness of the individual to adhere to their treatment plan and goals Cognitive Behavioral Therapy and Psychoeducation A Review of the Literature: A Review of the Literature Morrison, 2009- Individuals whose symptoms have been restraint to pharmaceutical treatments may benefit from Cognitive Behavioral Therapy Zimmer et al (2007)-focused on the effects of using Cognitive Behavioral Therapy on individuals’ cognition , social adjustment and quality of life Bechdolf et al (2004)- study involved using either Cognitive Behavioral Therapy or Psychoeducation Bechdolf et al (2010)- focus of this study was on how Cognitive Behavioral Therapy and Psychoeducation impacted the quality of life of individuals’ suffering from Schizophrenia Medalia et al (2012)- Study involving the impact that Psychoeducation has on the treatment for cognitive dysfunction in Schizophrenia patients Aho-Mustonen et al (2011)-Treatment discussed in this article was a combination of Psychoeducation and Cognitive Behavioral Therapy Research Question: Research Question Does the combination of Cognitive Behavioral Therapy and Psychoeducation help to decrease the cognitive symptoms displayed in individuals with schizophrenia? Research Methodology: Research Methodology Design ABA-BC-B-BC Single Subject Design 3 Base line measures will be used Independent Variable(s)- Cognitive Behavioral Therapy and Psychoeducation Dependent Variable(s)-Positive and negative cognitive symptoms of Schizophrenia Research Methodology: Research Methodology Cognitive Behavioral Therapy will be presented through: Weekly activities of assessment and engagement Problem solving and coping strategies Introducing techniques to improve self-esteem and relieve anxiety Psychoeducation will be presented to the individual through: Videos Handouts Research Methodology: Research Methodology Sample Female in her mid-fifties diagnosed with Schizophrenia Case study was selected among several offered by the instructor of Methods of Community Research class at Georgia State University Data Collection Procedures All treatments and activities will be conducted at the home of the subject 3 baseline measures will be conducted prior to the start of the first treatment phase Following the baseline measurements, the researcher will visit on Monday and Friday to administer either the Psychoeducation or the Cognitive Behavioral Therapy; Researcher will collect an assessment at the end of the week of a treatment phase The duration of the s tudy is 9 weeks Schedule of Treatment and Assessments: Schedule of Treatment and Assessments MONDAY TUESDAY WEDNESDAY THURSDAY FRIDAY SATURDAY SUNDAY 1 Baseline Measure Baseline Measure Baseline Measure 2 Psychoeducation Treatment Assessment of Treatment 3 4 Psychoeducation Treatment Assessment of Treatment 5 Cognitive Behavioral Treatment Assessment of Treatment 6 Psychoeducation Treatment Assessment of Treatment 7 Psychoeducation Treatment Assessment of Treatment 8 Cognitive Behavioral Treatment Assessment of Treatment 9 Final Measure of Treatment Methodology: Methodology Measures PANSS (Positive and Negative Symptoms Scale) Measures the severity of symptoms associated with Schizophrenia; Categories that the 30-question scale include: positive symptoms Negative symptoms General Psychopathology Scale has been shown to be a reliable tool and is “good at assessing the overall severity of Schizophrenia” ( Sanitor et al, 2007) PowerPoint Presentation:       PANSS RATING FORM     absent minimal mild moderate moderate severe severe extreme         P1 Delusions 1 2 3 4 5 6 7 P2 Conceptual disorganization 1 2 3 4 5 6 7 P3 Hallucinatory Behavior 1 2 3 4 5 6 7 P4 Excitement 1 2 3 4 5 6 7 P5 Grandiosity 1 2 3 4 5 6 7 P6 Suspiciousness/persecution 1 2 3 4 5 6 7 P7 Hostility 1 2 3 4 5 6 7 N1 Blunted affect 1 2 3 4 5 6 7 N2 Emotional withdrawal 1 2 3 4 5 6 7 N3 Poor rapport 1 2 3 4 5 6 7 N4 Passive/apathetic social withdrawal 1 2 3 4 5 6 7 N5 Difficulty in abstract thinking 1 2 3 4 5 6 7 N6 Lack of spontaneity & flow of conversation 1 2 3 4 5 6 7 N7 Stereotyped thinking 1 2 3 4 5 6 7 G1 Somatic concern 1 2 3 4 5 6 7 G2 Anxiety 1 2 3 4 5 6 7 G3 Guilt feelings 1 2 3 4 5 6 7 G4 Tension 1 2 3 4 5 6 7 G5 Mannerisms & posturing 1 2 3 4 5 6 7 G6 Depression 1 2 3 4 5 6 7 G7 Motor retardation 1 2 3 4 5 6 7 G8 Uncooperativeness 1 2 3 4 5 6 7 G9 Unusual though content 1 2 3 4 5 6 7 G10 Disorientation 1 2 3 4 5 6 7 G11 Poor attention 1 2 3 4 5 6 7 G12 Lack of judgment & insight 1 2 3 4 5 6 7 G13 Disturbance of volition 1 2 3 4 5 6 7 G14 Poor impulse control 1 2 3 4 5 6 7 G15 Preoccupation 1 2 3 4 5 6 7 G16 Active social avoidance 1 2 3 4 5 6 7                   Expected Findings and it’s Significance to the Field of Social Work: Expected Findings and it’s Significance to the Field of Social Work Cognitive Behavioral Therapy in conjunction with Psychoeducation will be an effective treatment for the symptoms of Schizophrenia Research on Psychoeducation is new; study will add to the growing research to the use of treatment approach Limitations to the study Sample size Lessons learned through this study Schizophrenia impacts the individual in ways that I was not aware of Proper chose of a design is very important when attempting to measure the effectiveness of an intervention or treatment References : References   National Institution of Mental Health. (2014). Schizophrenia. Retrieved from http://www.nimh.nih.gov/statistics/1SCHIZ.shtml Aho-Mustonen , K., Tiihonen , J., Repo- Tiihonen , E., Ryynänen , O., Miettinen , R., & Räty , H. (2011). Group psychoeducation for long-term offender patients with schizophrenia: An exploratory randomised controlled trial.  Criminal Behaviour & Mental Health ,  21 (3), 163-176. doi:10.1002/cbm.788 Bechdolf, A., Knost , B. B., Kuntermann , C. C., Schiller, S. S., Klosterkötter , J. J., Hambrecht, M. M., & Pukrop , R. R. (2004). A randomized comparison of group cognitive- behavioural therapy and group psychoeducation in patients with schizophrenia.  Acta Psychiatrica Scandinavica ,  110 (1), 21-28. doi:10.1111/j.1600-0447.2004.00300.x Bechdolf, A., Knost , B., Nelson, B., Schneider, N., Veith , V., Yung, A. R., & Pukrop , R. (2010). Randomized comparison of group cognitive behaviour therapy and group psychoeducation in acute patients with schizophrenia: effects on subjective quality of life. Australian & New Zealand Journal Of Psychiatry , 44 (2), 144-150. doi:10.3109/00048670903393571 References : References Medalia, A., Saperstein A., Choi K., & Choi, J. (2012), The efficacy of a brief psycho-educational intervention to improve awareness of cognitive dysfunction in schizophrenia. Psychiatric Research , 199 (3), 164-168. doi:10.1016/j.psychres.2012.04.042 Morrison, A. K. (2009). Cognitive behavior therapy for people with schizophrenia. Psychiatry , 6 (12), 32-39 Santor , D. A., Ascher-Svanum , H., Lindenmayer , J., & Obenchain , R. L. (2007). Item response analysis of the Positive and Negative Syndrome Scale. BMC Psychiatry , 7 doi:10.1186/1471-244X-7-66 Sheafor , B., Horejsi , C. (2012) Techniques and Guidelines for Social Work Practice, 9 th ed , 61-67 Zimmer, M., Duncan, A., Laitano , D., Ferreira, E., & Belmonte-de-Abreu, P. (2007). A twelve-week randomized controlled study of the cognitive-behavioral Integrated Psychological Therapy program: Positive effect on the social functioning of schizophrenic patients. Revista Brasileira De Psiquiatria , 29 (2), 140-147. doi:10.1590/S1516-44462006005000030

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