Psychosocial treatments for Schizophrenia

• Rehabilitation
• Psychotherapy
• Family education

For most people, treatment with anti-psychotic drugs is crucial for relieving the psychotic symptoms of schizophrenia, but the illness can have other effects on an individual's life and behaviour. Even when people with schizophrenia are relatively free of psychotic symptoms, many still have great difficulty dealing with daily life such as communicating with people around them, decision making, motivation, self care, and establishing and maintaining relationships with others. These areas of life may be influenced as schizophrenia generally occurs in early adulthood, and this is when people are developing independent social skills and a sense of how they fit in the world around them.

Psychosocial therapy may help an individual to manage their illness by helping them to discover new ways of coping psychologically and socially. Such treatments can support people to think more effectively about themselves, other people and their environment, so reducing the impact the illness has on their ability to manage with the social aspects of daily life.

Numerous forms of psychosocial therapy are available, but many have a cognitive and/or behavioural approach. This means that they look to support the person to think and behave more effectively, improving their ability to function socially in environments such as hospital, in the community, at home and in employment. Psychosocial therapy can be provided one to one by mental health professionals, in group settings, with the whole family or through education. It is increasingly common for a psychosocial approach to be used by mental health teams as part of their daily working practice.

Rehabilitation

Many people overcome difficulties and their improvement is aided by programmes such as problem solving, life skills, money management and support to re-enter education and work. Meeting others who are learning to overcome their difficulties can be a great help.

Psychotherapy

Psychotherapy is the treatment of emotional and mental disorders by verbal means, as opposed to drugs and physical measures. By sharing experiences with a trained empathic person (talking about their world with someone outside it) individuals with schizophrenia may gradually come to understand more about themselves and discover ways to manage their difficulties.

Individual psychotherapy

Individual psychotherapy involves regularly scheduled talks between the patient and a psychiatrist, psychologist, psychiatric social worker, or nurse. There are many different types of therapy, some being more or less suitable and not everybody finds it useful. It is important to gain advice about the best therapeutic approach for each individual's situation and how it will work alongside other treatments the patient may be receiving. The various therapies may focus on different issues such as current or past problems, experiences, thoughts, feelings, or relationships.

Cognitive Behavioural Therapy (CBT)

Cognitive behavioural therapy helps people to think about how they see themselves, the world and other people and how their actions can affect their thoughts and feelings.

CBT can help to change how people think ("Cognitive") and what they do ("Behaviour"). These changes can help people to feel better. Unlike some of the other talking treatments, CBT focuses on the "here and now" problems and difficulties. Instead of focussing on the causes of distress or symptoms in the past, it looks for ways to improve someone's present state of mind.

Family education

Very often, people with schizophrenia are discharged from the hospital into the care of their family; so 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 minimise the patient's chance of relapse.

Here are two examples:

• Family intervention which can help the whole family develop patterns of behaviour which promotes understanding and support
• Educational programmes can help to enlighten people about coping with their problems and inform them about the systems of care available e.g. health, housing and social services.