In addition to medications, other treatments may be beneficial for people with schizophrenia. These include:
Antipsychotic drugs help relieve the psychotic (positive) symptoms of schizophrenia (hallucinations, delusions, and incoherence). However, they do not necessarily relieve the behavioral symptoms of the disorder. Even when people 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 those with less severe symptoms or for people 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:
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 cognitive-behavioral (CBT) 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, people 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 person’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.
Self-help groups 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 US. These groups provide useful information and assistance for patients and families of individuals with schizophrenia and other mental disorders.
Electroconvulsive therapy (ECT) has improved dramatically in recent years. It is very effective in treating severe depression that does not respond to medication. It may also be helpful in some cases of schizophrenia that have not responded to conventional treatment. ECT involves a series of treatments in which the patient is sedated and receives mild electric stimulation. It may result in memory impairment that may last for several months.
Counseling therapies for schizophrenia. EBSCO DynaMed Plus website. Available at: http://www.dynamed.com/topics/dmp~AN~T903876/Counseling-therapies-for-schizophrenia. Updated July 19, 2016. Accessed March 14, 2017.
Dixon LB, Dickerson F, Belack AS, et al. The 2009 schizophreniaPORT psychosocial treatment recommendations and summary statements. Schizophr Bull. 2010;36(1):48-70.
Keshavan MS, Roberts M, Wittmann D. Guidelines for clinical treatment of early course schizophrenia. Curr Psychiatry Rep. 2006;8(4):329-334.
Moore DP, Jefferson JW. Handbook of Medical Psychiatry. 2nd ed. Philadelphia, PA: Elseverier Mosby; 2004.
Schizophrenia. EBSCO DynaMed Plus website. Available at: http://www.dynamed.com/topics/dmp~AN~T115234/Schizophrenia. Updated January 17, 2017. Accessed March 14, 2017.
Schizophrenia. Mental Health America website. Available at: http://www.mentalhealthamerica.net/conditions/schizophrenia. Updated . Accessed March 14, 2017.
Schizophrenia. National Institute of Mental Health website. Available at: https://www.nimh.nih.gov/health/topics/schizophrenia/index.shtml. Updated February 2016. Accessed March 14, 2017.
Stern TA, et al. Massachusetts General Hospital Comprehensive Clinical Psychiatry. 1st ed. Philadelphia, PA: Mosby Elsevier; 2008.
Last reviewed March 2017 by Adrian Preda, MD
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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