Schizophrenia and Psychotherapy
Dr. Randi Fredricks, Ph.D.
Many patients with schizophrenia have psychological distress that benefits from a combination of drugs and psychotherapy from a skilled therapist. Therapeutic techniques for helping the schizophrenic include teaching behavioral skills, remediating cognitive deficits, and psychoeducation.
Therapists use a number of psychotherapeutic approaches for schizophrenia that have been developed and researched. Of these various approaches to treatment, cognitive behavior therapy (CBT) has shown the most benefit for symptom reduction in schizophrenic outpatients.
In addition to CBT, other successful approaches include personal therapy, supportive-expressive therapy, compliance therapy, and acceptance and commitment therapy. Although these therapies have generally been studied separately, the approaches have overlap with respect to their therapeutic practices.
Personal Therapy and Psychosocial Intervention
Personal therapy is a psychosocial intervention designed to help patients with schizophrenia recognize and respond appropriately to arousing stimuli improves function and reduces relapse. Personal therapy aims to create a therapeutic safety net to protect the patients from undue personal stress.
Recent studies have suggested that over the long haul, individual psychotherapy tailored to strengthen interpersonal skills and control social stress markedly helps many people suffering from the schizophrenia.
Other forms of psychotherapy have been beneficial in the treatment of schizophrenia. Family therapy has clear results in the prevention of psychotic relapse and rehospitalization.
Art therapy, the use of art materials for self-expression and reflection in the presence of a trained art therapist, has proved useful for schizophrenia. This intervention has been used with schizophrenics, individually and in groups, in inpatient and outpatient settings as well as in the private sector. Two randomized controlled trials performed by psychologists suggested that art therapy was beneficial for schizophrenics, enabling them to experiencing meaningful expression.
The Importance of a Sensitive Therapist
Psychotherapy with schizophrenics should address three primary goals: to enhance skills for functional recovery, to provide emotional support, and to improve the underlying illness process.
Often psychotherapists don’t think therapy will be effective with individuals dealing with schizophrenia. In actuality a cognitive-relational psychotherapy approach helps form a warm, trusting and detached relationship, conveys an understanding and concern for one’s client, and involves the therapist telling that individual their own empathic views.
Fenton WS: Evolving perspectives on individual psychotherapy for schizophrenia. Schizophr Bull 2000; 26:47–72.
Hogarty GE, Kornblith SJ, Greenwald D, et al: Personal Therapy: a disorder-relevant psychotherapy for schizophrenia. Schizophr Bull 1995; 21:379–393.
Hogarty GE, Kornblith SJ, Greenwald D, et al: Three-year trials of Personal Therapy among schizophrenic patients living with or independent of family, I: description of study and effects on relapse rates. Am J Psychiatry 1997; 154:1504–1513.
Tarrier N, Yusupoff L, Kinney C, et al: Randomised controlled trial of intensive cognitive behaviour therapy for patients with chronic schizophrenia. BMJ 1998; 317:303–307.
Lehman AF, Carpenter WT, Goldman HH, et al: Treatment outcomes in schizophrenia: implications for practice, policy and research. Schizophr Bull 1995; 21:669–676.
About the Author
Randi Fredricks, Ph.D. is a practicing therapist, researcher and author specializing in the treatment of anxiety, depression, addiction, eating disorders, and related disorders. Dr. Fredricks is a best-selling author of several books including Healing & Wholeness: Complementary and Alternative Therapies for Mental Health a 650-page compendium and landmark publication that provides a comprehensive overview of complementary and alternative treatments for mental health. For more information on Dr. Fredricks work, visit her practice website San Jose Counseling and Psychotherapy.