Treatment According to the Interactionist Model (AQA A Level Psychology): Revision Note

Cognitive & biological treatments

• The interactionist approach to treating schizophrenia is to combine both drug therapy with cognitive behavioural therapy (CBT)

• The ‘interaction’ element of the interactionist approach refers to the idea that schizophrenia may not have one true cause and may in fact develop due to a range of factors so it makes sense to treat both the biological and the psychological/cognitive symptoms/effects of the illness (as suggested by the diathesis-stress model)

• Drug therapy consists of the use of antipsychotic medication which addresses the possible biological cause of schizophrenia

• Psychological/cognitive therapy consists of CBT which is a talking therapy aimed at enabling the client to cope with their symptoms and to manage their dysfunctional thoughts and behaviours

• Interactionist treatment usually starts with the patient taking antipsychotic medication to control their symptoms, followed by CBT: this process is designed to enable the schizophrenic person to be able to participate in CBT more successfully, as the drug therapy should have reduced some of their symptoms prior to the CBT sessions

• The interactionist approach to treating schizophrenia is more common in the UK compared to, for example, the USA which has a history of struggling to combine both biological and psychological approaches to treatment

Research which investigates treatment using the interactionist approach

• Tarrier et al. (2004) found that patients (total sample size = 315) who were prescribed a combination of drug therapy and CBT showed reduced symptoms compared to patients who were prescribed drugs only 

• Guo et al. (2010) – patients who followed an interactionist treatment regimen whilst in the early stages of schizophrenia showed improvement in their symptoms and were less likely to relapse than those who took drugs alone

• Morrison et al. (2018) conducted a single-blind pilot study with 75 schizophrenic patients in Manchester: patients were allocated to drugs-only, CBT-only or a combination of CBT plus drugs and the findings showed that the combination condition was the most promising for the successful treatment of first-episode schizophrenia

Evaluation of treatment using the interactionist approach

Strengths

• Strong supporting evidence, as seen in, for example, Tarrier et al. (2018) above, gives the interactionist approach good validity

• Using the interactionist approach may prove to be cost-effective (i.e., good for the economy) if it is more successful than other treatments, as the patient will improve more quickly and is less likely to relapse, saving money on health services and getting the patient back into the workplace more quickly 

Limitations

• The interactionist approach may not suit all patients

  • Some may have difficulty understanding or interpreting the side-effects of their drugs, which CBT could actually worsen with its emphasis on challenging dysfunctional thoughts

    • In other words, the effects of the drug may be exacerbated by the process of CBT

• The treatment-causation fallacy suggests that the interactionist approach may be mistaken in treating the (supposed) biological causes of the illness first as there is no hard evidence that schizophrenia has its roots in biological factors

Issues & Debates

• The interactionist approach supports the diathesis-stress model, recognising both biological (nature) and psychological/social (nurture) influences on schizophrenia

  • This makes treatment more comprehensive, addressing symptoms through antipsychotics (biological) and CBT (psychological)

• Unlike purely biological or psychological treatments, the interactionist model is holistic, combining therapies to reflect the complex and multifactorial nature of schizophrenia

  • This makes it more suitable for addressing both positive and negative symptoms, increasing its real-world effectiveness