Interactionist Treatments (AQA A-Level Psychology): Revision Notes
Interactionist Treatments
The interactionist approach to treating schizophrenia recognises that the condition has multiple causes and therefore requires multiple treatment methods working together. Rather than relying on a single intervention, this approach combines different types of treatments to address the various biological, psychological, and social factors that contribute to schizophrenia.
Understanding combination treatments
Researchers evaluate the effectiveness of different schizophrenia treatments by comparing their outcomes. Evidence consistently shows that combination treatments, where multiple interventions are used simultaneously, tend to be more effective than single treatments alone. The most common combination involves pairing biological treatments (typically antipsychotic medication) with psychological therapies such as cognitive behavioural therapy (CBT) or family therapy.
The rationale behind this approach is straightforward: if schizophrenia involves both biological vulnerabilities and psychological/social factors, then treatment should address all these components. Antipsychotic drugs typically reduce positive symptoms like hallucinations and delusions, while psychological therapies help patients develop coping strategies and improve their social functioning.
Research evidence
Several important studies demonstrate the effectiveness of interactionist treatments:
Research Study: Hogarty et al. (1986)
Conducted a comprehensive study examining relapse rates in 103 patients with schizophrenia from families with high expressed emotion. They compared various treatment combinations and found striking differences in first-year relapse rates:
- Family therapy plus drugs: 19%
- Social support therapy plus drugs: 20%
- Drug treatment alone: 41%
- Family therapy plus social support and drug therapies: 0%
This research strongly supports combining treatments to improve effectiveness. However, a follow-up study revealed that the combined treatment only delayed relapse rather than preventing it entirely.
Research Study: Guo et al. (2010)
Focused on patients in early stages of schizophrenia, comparing those receiving combined antipsychotic and psychological therapy with those taking antipsychotics alone.
Key findings:
- Improved insight in combination group
- Better quality of life
- Enhanced social functioning
- Less likely to discontinue treatment or experience relapse
This demonstrates the practical benefits of integrated approaches.
Sudak (2011) reported that combining antipsychotic medication with CBT strengthens patient adherence to drug treatment. The CBT component helps patients develop rational insight into the benefits of medication compliance, thereby increasing their chances of improvement and reducing discontinuation rates.
Morrison & Turkington (2014) provided further evidence that drug treatment combined with CBT produces superior outcomes compared to either intervention alone, with better symptom reduction rates and lower relapse rates.
Evaluation of interactionist treatments
Strengths
Comprehensive approach: Combination treatments are particularly effective because cognitive and behavioural therapies address different aspects of the condition. Cognitive therapies help restructure disordered thinking patterns, while behavioural therapies teach practical social skills and coping strategies for real-life situations. Without the cognitive restructuring component, behavioural interventions would be less effective.
Addresses multiple components: Since schizophrenia often involves both biological and psychological elements, combined treatments make logical sense. Biological interventions like medication target the neurochemical aspects, while psychotherapeutic treatments address psychological and social factors.
Enhanced long-term cost-effectiveness: Although combination treatments increase initial treatment costs, their greater effectiveness can make them more economical in the long term by reducing relapse rates and hospitalisation needs.
Weaknesses
Increased complexity and cost: Implementing multiple treatments simultaneously requires more resources, specialist staff, and coordination, making the approach more expensive than single interventions.
Patient confusion and resistance: Some patients receiving CBT may misinterpret the side effects of concurrent drug treatment, viewing them suspiciously. This can increase mistrust of healthcare providers and resistance to continuing treatment, potentially undermining the therapeutic relationship.
Individual variation: Not all patients require or benefit from combination approaches. Some may respond adequately to single treatments, making the additional interventions unnecessary and potentially overwhelming.
Key Points to Remember:
- Combination treatments consistently outperform single treatments for schizophrenia, particularly when combining antipsychotics with psychological therapies
- Research evidence from multiple studies shows significantly lower relapse rates with combined approaches (as low as 0% in some studies)
- CBT combined with medication improves drug adherence and provides patients with better coping strategies
- Cost considerations are important - while initially more expensive, combination treatments may be more cost-effective long-term due to reduced relapse rates
- Patient-centred approach is essential - the specific combination should match individual circumstances, such as family dynamics and social support needs