a wide array of non-medical interventions for those with schizophrenia.
These programs emphasize social and vocational training to help
patients and former patients overcome difficulties in these
areas. Vocational counseling, job training, problem-solving
and money management skills, use of public transportation, and
social skills training are some of the services that may be
used . These approaches are important for the success of the
community-centered treatment of schizophrenia, because they
provide discharged patients with the skills necessary to lead
productive lives outside the sheltered confines of a mental
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 empathic
person-talking about their world with someone outside it-individuals
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. Recent studies indicate
that supportive, reality-oriented, individual psychotherapy,
and cognitive-behavioral approaches that teach coping and problem-solving
skills, can be beneficial for outpatients with schizophrenia.
However, psychotherapy is not a substitute for antipsychotic
medication; it is most helpful once drug treatment first has
relieved a patient's psychotic symptoms.
|Very often, patients
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 minimize the patient's chance
of relapse-for example, by using different treatment adherence
strategies-and to be aware of the various kinds of outpatient
and family services available in the period after hospitalization.
Family "psychoeducation," which includes teaching
various coping strategies and problem-solving skills, may help
families deal more effectively with their ill relative and may
contribute to an improved outcome for the patient.
for people and families dealing with schizophrenia are becoming
increasingly common. Although not led by a professional therapist,
these groups may be therapeutic because members provide continuing
mutual support as well as comfort in knowing 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 as a group
rather than individually may be better able to dispel stigma
and draw public attention to such abuses as discrimination against
the mentally ill.
Family and peer support and advocacy groups are very active
and provide useful information and assistance for patients and
families of patients with schizophrenia and other mental disorders.