Psychotherapy for Schizophrenia & Clinical Depression (OCR GCSE Psychology): Revision Note

What is psychotherapy?

• Psychotherapy is a form of talking therapy, first developed by Freud, that helps people understand and manage thoughts, feelings, and behaviours

• Modern psychotherapy often combines psychological techniques with the behaviourist approach, such as cognitive behavioural therapy (CBT)

• CBT is now widely used to treat a range of mental health conditions, including clinical depression, schizophrenia, and phobias

What is CBT?

• CBT is based on the idea that negative or irrational thoughts affect how we feel and act

• Over time, these thinking patterns can become automatic and harmful

• CBT combines:

  • Cognitive strategies – identifying and challenging negative thoughts

  • Behavioural strategies – changing unhelpful behaviours and building practical coping skills

• CBT focuses on current problems, not on exploring childhood experiences or past trauma

• It is typically short-term (5–20 sessions), delivered one-to-one, in groups, or online

Theoretical basis

• CBT is based on Ellis’s ABC model, which explains how thoughts influence emotions and behaviour:

  • A – Activating event (something that happens)

  • B – Beliefs about the event (often negative or irrational)

  • C – Consequence (emotional and behavioural response)

• Ellis later added:

  • D - Disputing (challenging irrational beliefs)

  • E - Effect (of adopting healthier beliefs)

• CBT is also based on Beck’s cognitive theory, which focuses on challenging distorted thinking and rebuilding more balanced interpretations of situations

How therapy works

• Clients work with the therapist to identify problematic thoughts and beliefs

• Together they break these thoughts down into patterns and examine how they affect emotion and behaviour

• Clients often complete homework, such as thought diaries, behavioural experiments, or worksheets, to practise new skills between sessions

• The aim is for clients to learn long-term coping strategies and prevent relapse

The use of psychotherapy for schizophrenia

• CBT is used alongside antipsychotic medication to help people manage symptoms such as:

  • delusions

  • hallucinations

  • negative symptoms (e.g., lack of motivation, apathy)

• Beck (1952) demonstrated that delusional beliefs can be treated using cognitive techniques

• The therapist takes a non-judgemental and collaborative approach, helping clients:

  • explore their delusional beliefs safely

  • question and test the evidence for their beliefs

  • re-evaluate what their voices say (in the case of hallucinations)

  • develop coping strategies for intrusive or distressing symptoms

Examples

• A client who believes the therapist’s chair contains a microphone may be encouraged to check the chair with the therapist to see whether this belief is realistic

• A person hearing threatening voices may work with the therapist to test the accuracy and meaning of what the voices say

How CBT improves mental health in schizophrenia

• Reduces fear and distress linked to hallucinations or delusions

• Helps clients understand their symptoms instead of trying to suppress them

• Strengthens reality testing and insight into the condition

• Can improve motivation and daily functioning by challenging negative thought patterns and setting achievable goals

• Builds insight into the condition, helping individuals recognise when symptoms are worsening and apply coping techniques early

Effectiveness

• Research shows CBT is effective in reducing distress and improving functioning, especially when combined with antipsychotic medication

• Useful because it addresses current symptoms, providing practical strategies for dealing with hallucinations, delusions, and negative symptoms

The use of psychotherapy for clinical depression

• People with depression often interpret events in negative, pessimistic ways, reinforcing low mood

• CBT helps individuals:

  • identify these distorted beliefs (e.g., “I always fail” and “Nobody likes me”)

  • challenge and re-evaluate them through discussion and cognitive restructuring

  • replace them with more realistic, balanced thoughts

How CBT improves mental health in clinical depression

• Breaks the cycle of negative thinking, low mood, and withdrawal

• Builds coping skills for handling everyday stress, problem-solving, and emotional regulation

• Encourages behavioural activation (increasing rewarding activities)

• Improves self-esteem, problem-solving ability, and emotional resilience

• Helps prevent relapse by teaching the client to challenge negative thoughts independently

Effectiveness

• CBT is effective for moderate and severe depression

• Works particularly well when combined with antidepressant medication, addressing both biological and psychological aspects

• Focuses on present issues, making treatment practical and solution-focused