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Art Therapy for Psychosis — MRCPsych Paper B MCQ

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ModerateSchizophrenia & PsychosisArt Therapy for PsychosisMRCPsych Paper B

A 24-year-old man is receiving early-intervention care for a first episode of schizophrenia. Oral antipsychotic medication, individual cognitive behavioural therapy and family intervention have been arranged. He remains socially withdrawn, speaks little and shows reduced emotional expression and motivation. There is no prominent depression, sedation or extrapyramidal adverse effect. According to NICE CG178, which additional psychological intervention should be considered particularly for the alleviation of these negative symptoms?

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Correct answer: B — Arts therapy

Explanation lettering: D = shown as A · C = shown as B · A = shown as C · E = shown as D · B = shown as E

C is correct. NICE CG178 recommends considering arts therapies for people with psychosis or schizophrenia, particularly for alleviating negative symptoms. These include art, music, dance-movement and drama therapies. The stem also excludes common secondary causes of apparent negative symptoms, such as depression, antipsychotic sedation and extrapyramidal adverse effects. Individual CBT is routinely offered in first-episode psychosis and can support recovery, but it is already arranged and is not the additional intervention specifically highlighted here. Family intervention is also part of standard first-episode care when the family is in close contact. Psychodynamic psychotherapy is not recommended as a specific routine treatment, while counselling and supportive psychotherapy should not routinely be offered.

Reference: National Institute for Health and Care Excellence. Psychosis and schizophrenia in adults: prevention and management (CG178), recommendations 1.4.4.1–1.4.4.6. 2014; reviewed 2025. https://www.nice.org.uk/guidance/cg178/chapter/recommendations