psychotherapy for schizophrenia

the authors note that the most common treatment for patients with schizophrenia is a combination of prescription antipsychotic medications and some form of individual psychotherapy. the authors identify two theoretical traditions in the history of psychotherapy for schizophrenia. the generally disappointing results from randomized clinical trials and follow-up studies contributed to a decline in the influence of a psychodynamic and intensive individual psychotherapy approach for schizophrenia, and to the increased ascendancy of the biological paradigm. the cbt group showed reductions in symptom severity and number of positive symptoms.

as compared with the routine care group, the cbt group showed a statistically significant reduction in distress from delusions and a reduction in preoccupation with delusions. both groups showed statistically significant change at the end of treatment as measured by the brief psychiatric rating scale, a scale measuring positive symptoms, and a third scale measuring negative symptoms. comment: this is one of the best-designed studies reviewed and shows results comparable to the others. in general, the best results occurred with the combination of focused psychotherapy, medication management, and a stable living environment for patients.

schizophrenia is a pervasive psychiatric disorder that typically has its onset in early adulthood and persists for the remainder of the lifespan. many patients with schizophrenia have psychological distress and may receive some form of psychotherapy, the models for which continue to evolve. another recent variation of cbt, functional cbt, has been developed in the united states (cather et al., 2005) and is a 16-session weekly individualized therapy for residual psychotic symptoms. the largest meta-analysis of cbt trials for psychosis was based on the results of 34 studies, most of which were performed in the united kingdom, and that included a total of 1964 patients, most of whom are with schizophrenia (wykes et al., 2008). the therapy is based on a cognitive model in which defeatist beliefs and negative expectancies are conceptualized as interacting with patients’ cognitive deficits and contributing to negative symptoms (grant and beck, 2009). although personal therapy and cognitive behavior therapy for schizophrenia were developed independently, they share some common elements as shown in table 1. unlike some other psychotherapy approaches, personal therapy is staged to the patient’s degree of recovery from an acute psychotic episode. acceptance and commitment therapy (act) is a variation on cbt and was also originally developed for the treatment of non-psychotic conditions (hayes et al., 1999). evidence on the possible effectiveness of supportive therapy for schizophrenia comes indirectly from the results of recent clinical trials in which it was provided as a control or comparison condition to cbt (penn et al., 2004). first, as articulated by lysaker and lysaker (2008), “dialogical therapy” focuses on the development of the capacity for interpersonal and intrapersonal dialogues that organize self-experience, the relative lack of which often leads to a fragmented sense of self in persons with schizophrenia (lysaker and lysaker, 2008).

our current understanding is also that persons with schizophrenia are capable of personal growth and of achieving meaningful life goals in the face of ongoing illness symptoms. recovery in this context is focused less on the reduction of illness symptoms and more on an increase in psychological adaptation to the illness. 19:340–349.crossref, google scholar bach p, hayes sc (2002) the use of acceptance and commitment therapy to prevent the rehospitalization of psychotic patients: a randomized controlled trial. 25:11–24.crossref, google scholar deegan pe (2005) the importance of personal medicine: a qualitative study of resilience in people with psychiatric disabilities. 68:730–737.crossref, google scholar grant pm, beck at (2009) defeatist beliefs as a mediator of cognitive impairment, negative symptoms, and functioning in schizophrenia. 10:564–598.crossref, google scholar haddock g, tarrier n, morrison ap, hopkins r, drake r, lewis s (1999) a pilot study evaluating the effectiveness of individual inpatient cognitive-behavioural therapy in early psychosis. 7:75–91.crossref, google scholar lysaker p, lysaker j (2008) schizophrenia and the fate of the self. 30:101–112.crossref, google scholar perez-alvarez m, garcia-montes jm, vallina-fernandez o, perona-garcelan s, cuevas-yust c (2011) new life for schizophrenia psychotherapy in the light of phenomenology. 74:136–144.crossref, google scholar tarrier n, kinney c, mccarthy e, humphreys l, wittkowski a, morris j (2000) two-year follow-up of cognitive-behavioral therapy and supportive counseling in the treatment of persistent symptoms in chronic schizophrenia. 34:523–537.crossref, google scholar zimmermann g, favrod j, trieu vh, pomini v (2005) the effect of cognitive behavioral treatment on the positive symptoms of schizophrenia spectrum disorders: a meta-analysis.

individual psychotherapy. during sessions, a therapist or psychiatrist can teach the person how to deal with their thoughts and behaviors. they’ the therapy focuses on a thorough examination of the patient’s life history and current relationships and on the doctor–patient relationship. patients with five main approaches to psychosocial intervention had been used for the treatment of schizophrenia: cognitive therapy (cognitive behavioral, .

of these approaches, cognitive behavior therapy (cbt) has the strongest evidence base and has shown benefit for symptom reduction in outpatients psychotherapy for schizophrenia is typically part of a well-rounded treatment plan for this mental health condition. while medications can help types of psychological treatment for schizophrenia include cognitive behavioural therapy (usually called cbt), psychoeducation and family psychoeducation., .

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