In addition to medications, other treatments may be beneficial for patients with schizophrenia. These include:
Antipsychotic drugs help relieve the psychotic or “positive” symptoms of
(hallucinations, delusions, and incoherence). However, they do not necessarily relieve the behavioral symptoms of the disorder. Even when patients with schizophrenia are relatively free of psychotic symptoms, many still have difficulty with communication, motivation, self-care, and establishing and maintaining relationships with others. People often develop schizophrenia during the critical career-forming years of life (ages 18-35). Therefore, they are less likely to complete the training required for skilled work. As a result, many individuals with schizophrenia not only suffer from thinking and emotional difficulties, but also lack social and work skills.
Psychosocial treatments may help with these psychological, social, and occupational problems. They may have limited value for acutely psychotic patients (those who are out of touch with reality or have strong hallucinations or delusions). However, they may be useful for patients with less severe symptoms or for patients whose psychotic symptoms are under control.
Numerous forms of psychosocial therapy are available for people with schizophrenia. Most focus on improving the patient’s social functioning, whether in the hospital, community, at home, or on the job. The availability of different forms of treatment varies greatly from place to place.
Rehabilitation includes a wide range of non-medical interventions. Rehabilitation programs emphasize social and vocational training to help patients and former patients overcome difficulties in these areas. Programs may include:
- Vocational counseling
- Job training
- Problem-solving and money management skills
- Use of public transportation
- Social skills training
These approaches are important for the success of the community-centered treatment of schizophrenia. They provide discharged patients with the skills necessary to lead productive lives outside the sheltered confines of a mental hospital.
Individual psychotherapy involves regularly scheduled talks between the patient and a mental health professional such as a psychiatrist, psychologist, psychiatric social worker, or nurse. The sessions may focus on current or past problems, experiences, thoughts, feelings, or relationships. By sharing experiences with a trained therapist, people with schizophrenia may gradually come to understand more about themselves and their problems. They can also learn to sort out the real from the unreal and distorted.
Supportive, reality-oriented, individual psychotherapy, and
approaches that teach coping and problem-solving skills can be beneficial for many people with schizophrenia. However, psychotherapy is not a substitute for antipsychotic medication. This approach is most helpful after drug treatment has relieved a patient’s psychotic symptoms.
Very often, patients with schizophrenia are discharged from the hospital into the care of their family. For this reason, it is important that family members learn all they can about schizophrenia and understand the difficulties and problems associated with the illness. It is also helpful for family members to learn ways to minimize the patient’s chance of relapse. They may need to be aware of different treatment adherence strategies and the various outpatient and family services available in the period after hospitalization. Family “psychoeducation” includes teaching coping strategies and problem-solving skills. This approach may help families deal more effectively with their relative. It may also contribute to an improved outcome for the patient.
Family members should be made aware that they did not cause the illness.
are often available for people and families dealing with schizophrenia. Although not led by a professional therapist, these groups may be therapeutic because members provide continuing mutual support. They provide comfort in helping patients know that they are not alone in the problems they face. Self-help groups may also serve other important functions. Families working together can more effectively serve as advocates for needed research and hospital and community treatment programs. Patients acting together as a group—rather than as individuals—may be better able to remove certain stigmas associated with schizophrenia. They can also draw public attention to abuses such as discrimination against those with mental illnesses.
There are many active family and peer support groups as well as advocacy groups for schizophrenia in the United States. These groups provide useful information and assistance for patients and families of individuals with schizophrenia and other mental disorders.