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CBT Training for Schizophrenia Comes to Canada

This year SSO brought a training program to Canada for the first time, making more support options available to those who need it most. 

In the fall of 2015, SSO staff attended a cognitive behaviour therapy (CBT-p) training for psychosis session in Ottawa facilitated by world renowned professor Dr. Douglas Turkington, Professor of Psychosocial Psychiatry at Newcastle University, UK. Seeing the potential that the program could have for Canadians, Purple Weber, early intervention family worker and Sheila Deighton, regional lead in Eastern Ontario, began to look into the possibility of bringing a CBT-p based training program to Canada.
“In Canada when you receive treatment for mental illness, the treatment is medicine. There isn’t much outside of that,” Purple says. “During recovery, people need other tools combined with medication to help them maintain wellness – CBT-p can fill this gap.”

CBT-p is an evidence-based therapy that has been effective in the treatment of mental illness including chronic depression and anxiety. Using CBT-p to treat psychosis is fairly new, but research in to the the outcomes have been positive. In Ontario, while CBT-p treatment is provided by some psychologists, it is expensive, not covered under the provincial health plan, and can be difficult to find.

This spring, Dr. Turkington and his team, including researchers Latoyah Lebert and Maggie Douglas-Bailey, arrived in Ontario to deliver a suite of trainings, including a two day introductory training to family members and caregivers and a week-long training for caregivers who were interested in a more hands-on training in an intimate group setting.

“Caregivers do not have the tools and are not getting the support they need from the system,” Dr. Turkington said to the caregivers. “I hear a lot of anger from caregivers and my main focus is to empower you with information.”

A large number of people living with schizophrenia live at home with family members. It is the family members who have to provide care and treatment, while also looking for support and services that are often limited and hard to find.

During the workshops, caregivers were introduced to coping strategies to help loved ones during occurrences of hallucinations, delusions and disorganized thoughts.

Some of the techniques included playing music, singing or reading loudly when someone is experiencing hallucinations to help redirect their thoughts. With delusions, caregivers can try to “normalize” the symptom by helping them make sense of where these thoughts are coming from. Normalizing these symptoms includes letting a loved one know that many people experience hearing voices at different points in their life.

According to Dr. Turkington, eight per cent of the population will experience hearing voices during times of trauma, grief, lack of sleep or stress. Caregivers were also encouraged to make connections with their loved ones, outside of the illness.

“Befriending is about being supportive, accepting and non-confrontational,” says Purple. “These skills can be easily applied to everyday life and Dr. Turkington focused on evidence that proves these skills can be effective.”

Dr. Turkington and his team used a variety of teaching techniques, including role play. In an interactive exercise incorporating the audience, Dr. Turkington would play someone living with schizophrenia or the therapist; or in some cases play the voice, to illustrate what it would be like to hear voices. Latoyah or Maggie would play opposite him and facilitate audience participation. They would ask the audience for suggestions of ways to handle the situation and employ the techniques they had learned about.

Family member Linda Zlepnig has a son who lives with schizophrenia heard about the program from Sheila Deighton and attended both the two day workshop in Toronto and the five day program in Ottawa. “I was interested in the program because I wanted to learn more about CBT-p and see if I could apply any of its techniques with my son,” Linda says. “I enjoyed all of the training but the five day program was fantastic. We were able to have time to practice with Dr. Turkington and his team.”  

Now Linda hopes to learn more about CBT-p and hopefully facilitate groups to teach these techniques to others. “The most helpful thing I learned from the training was the concept of normalizing symptoms. Now when I’m with my son I have a better understanding of what he's is going through,” Linda says. “Now I have hope that my son can recover and have a good quality of life.”

Other participants echoed these thoughts, one family member sharing, “Since the program I have used the techniques with my family member. It’s easier now to recognize their triggers, and understand their beliefs and thoughts. There is still a lot of information for me to go over but I believe that my family member can get better and live well.”

The next steps for the CBT-p program are to standardize the program and work towards expanding it so it is available for healthcare professionals and caregivers across Canada.