People can also learn to manage their symptoms and improve their functioning with psychosocial treatment and rehabilitation. The treatments listed here are ones which research have shown to be effective for people with schizophrenia. They are considered to be evidence-based practices.
What is Evidence-Based Practice for Schizophrenia?
Research has shown that the treatments listed here are effective for people with schizophrenia and are considered to be evidence-based. Evidence-based practice means the therapist takes three important things into consideration: their own expertise, the patient’s preferences and values, and scientific evidence to guide which treatments they use. Treatments that have research showing they are effective are called evidence-based treatments.
Evidence-based treatments for schizophrenia include:
- Social Skills Training
- Family-based services
- Supported Employment
- Cognitive Behavioral Therapy (CBT)
- Assertive Community Treatment (ACT)
- Illness Self-Management
- Psychosocial Interventions for Alcohol and Substance Use Disorders
- Psychosocial Interventions for Weight Management
The post titled “Antipsychotic Medication: What You Should Know” provides information about antipsychotic medications and their side effects.
Social Skills Training
Many people with schizophrenia have difficulties with effective social skills. Social skills training aims to correct these deficits by teaching socially appropriate ways to express emotion and make requests, so individuals are more likely to achieve their goals, develop relationships, and live independently. Social skills are taught in a very systematic way using behavioral techniques, such as modeling, role playing, positive reinforcement, and shaping.
Mental illness affects the whole family. Family treatment and psychoeducation is one way families can work together towards recovery. The family and clinician meet together to discuss the problems they are experiencing. Families then attend educational sessions where they will learn basic facts about mental illness, coping skills, communication skills, problem-solving skills, and ways to work together toward recovery. Patients who participate in family interventions report fewer psychiatric symptoms, improved work functioning, and improved treatment adherence. Family members also benefit and report feeling more satisfaction with their relationship and less burden. There are a range of family programs available. Some families benefit from just a few sessions. More intensive services are especially helpful for families that are experiencing high levels of stress and tension and for patients who are chronically symptomatic or prone to relapse. These longer-term interventions generally last 6-9 months and can be done in single family or multi-family formats.
Research shows that about 70% of adults with severe mental illness want to work and about 60% can be successfully employed when using Supported Employment. Supported Employment is designed to help people with severe mental illness find and keep competitive employment. The approach is characterized by focus on competitive work, rapid job search, absence of prevocational training, and continued support once a job is obtained. Employment specialists work with individuals to identify their career goals and personal abilities. Case managers and mental health providers work closely with employment specialist to provide support during the job seeking and keeping process.
Cognitive Behavioral Therapy (CBT)
Cognitive behavioral therapy (CBT) is a blend of two therapies: cognitive therapy and behavioral therapy. Cognitive therapy focuses on a person’s thoughts and beliefs, and how they influence a person’s mood and actions, and aims to change a person’s thinking to be more adaptive and healthy. Behavioral therapy focuses on a person’s actions and aims to change unhealthy behavior patterns. Treating schizophrenia with CBT is challenging. The disorder usually requires medication first. But research has shown that CBT, as an add-on to medication, can help a person better cope with schizophrenia. CBT for schizophrenia is skill-oriented. Patients learn skills to cope with life’s challenges. The therapist teaches social skills, skills related to daily functioning, and problem-solving skills. Patients learn to identify what triggers episodes of the illness, which can prevent or reduce the chances of relapse. This can help patients with schizophrenia minimize the types of stress that can lead to hospitalizations. CBT also helps patients learn more adaptive and realistic interpretations of events. Patients are also taught various coping techniques for dealing with “voices” or other hallucinations. Therapy may be done one-on-one or in a group setting.
Assertive Community Treatment (ACT)
Assertive Community Treatment (ACT) is an approach that is most effective for individuals with the greatest service needs, such as those with a history of multiple hospitalizations or those who are homeless. In ACT, the person receives treatment from an interdisciplinary team of usually 10 to 12 professionals, including case managers, a psychiatrist, several nurses and social workers, vocational specialists, substance abuse treatment specialists, and peer specialists. The team provides coverage 24 hours, 7 days per week, and utilizes small caseloads, usually 1 staff for every 10 clients. Services provided include case management, comprehensive treatment planning, crisis intervention, medication management, individual supportive therapy, substance abuse treatment, rehabilitation services (i.e. supported employment), and peer support.
Components of illness self-management include psychoeducation, coping skills training, relapse prevention, and social skills training. Individuals learn about their psychiatric illness, their treatment choices, medication adherence strategies, and coping skills to deal with stress and symptoms. Relapse prevention involves recognizing situations that might trigger symptoms, tracking warning signs and symptoms of relapse, and developing a plan to cope with triggers and warning signs to prevent relapse. This treatment approach also teaches individuals social skills in order to improve the quality of their relationships with others.
Psychosocial Interventions for Alcohol and Substance Use Disorders
Many individuals with schizophrenia also struggle with an alcohol or substance use disorder. Co-occurring disorders are best treated concurrently, meaning that treatment for schizophrenia should be integrated with the treatment for the alcohol or drug problem. Integrated treatment includes motivational enhancement and cognitive-behavioral interventions. Integrated treatments are effective at reducing substance use, preventing relapse, and keeping individuals in treatment longer. These interventions can be delivered one-on-one or in a group format.
Psychosocial Interventions for Weight Management
Weight gain is one of the most significant and frustrating side effects of many medications used to treat the symptoms of schizophrenia. Weight gain can lead to problems such as diabetes and hypertension making it a serious problem for many individuals. Help with weight loss is available. Weight programs generally last three months or longer and include education about nutrition and portion control. Participants learn skills to monitor their daily food and activity levels, have regular weigh-ins, and set realistic and attainable personal goals. Participation in such a program can help prevent additional weight gain and lead to modest weight loss.
Keep Learning and Find Support
The most important thing is to keep learning about schizophrenia and find a safe place to ask questions and feel supported. We offer a free private Facebook group for families with schizophrenia and bipolar disorder. You can also subscribe to receive our newsletter so that you can receive our latest blog posts.
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